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Identifying Complex Patients Using Adjusted Clinical Groups Risk Stratification ToolIn this study, the authors developed a method for use in primary care to identify a group of patients with complex care needs using Aggregated Diagnosis Groups.
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Association of 340B Contract Pharmacy Growth With County-Level CharacteristicsThe growth of 340B contract pharmacies since 2010 is unprecedented. This study’s findings suggest that patterns of growth differ between safety-net clinics and hospitals.
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Impact of Payment Models on Medical Specialist Physician Practice PatternsThis article explores the impact of payment models (fee for service vs salary based) on practice patterns, including wait times and care for patients with chronic diseases.
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Integrating Primary Care and Public Health for Advance Care PlanningThis article proposes a new model, Public-Primary ACP, that leverages coordination between primary care and public health workforces to improve delivery of advance care planning.
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People Experiencing Homelessness in Miami: Insurance Enrollment Rates, Hypertension TrendsPeople experiencing homelessness face significant barriers to health care access, leading to higher rates of hypertension even among those with health insurance.
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Reimbursement for Genetic Variant Reinterpretation: Five Questions Payers Should AskPeriodic reinterpretation of genetic sequencing results presents a challenge for developing transparent and systematic coverage and reimbursement policies.
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Contributor: The Connection Between Gout and CVD Requires Cross-Specialty CollaborationThe Panicos are on a mission to change how we think about gout. Why? As a husband-and-wife DO duo, the Panicos each have a unique perspective on gout and how physicians in their respective fields can better collaborate to help patients who live with this systemic disease.
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Financial Factors That Influenced Telemedicine Delivery During the COVID-19 PandemicThis study describes financial issues that influenced telemedicine provision and use for patients with chronic conditions and their providers during COVID-19.
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Telehealth User Experiences During COVID-19: A Case Study of Outpatient Cardiovascular Clinics Affiliated With a Large Academic PracticeIn cardiovascular clinics during COVID-19, notable barriers to successful telehealth use included obtaining diagnostic information needed to deliver high-quality care and technology-related challenges for patients.
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Proactive Care Management of AI-Identified At-Risk Patients Decreases Preventable AdmissionsProactive care management for artificial intelligence (AI)–identified at-risk patients reduced potentially preventable hospital admissions.
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To Report or Not Report Health Care Data BreachesThis study presents information regarding the decisions that health care privacy officers make about reporting a data breach, including factors that can affect the decision process, such as personal/organizational knowledge, prior breach status, and framed scenarios.
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Eliminating Defects in Value: Turnaround of an MSSP ACOA health system transformational leadership framework and management system made visible and eliminated defects in value and was associated with reduced annual Medicare expenditures and increased quality between 2017 and 2020.
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Pharmacist Hypertension Management Using an Electronic Health Record–Based ApproachThe authors studied the impact of a pharmacist intervention on blood pressure control compared with usual care.
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A Clinical Pathway to Well-Being: Putting Patient Priorities at the Center of CareUsing patient priorities and converting them into treatment goals result in better primary care outcomes for Medicare patients.
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Rising Use of Surveillance Colonoscopy and Potential ImpactsThe proportion of colonoscopies performed for postpolypectomy surveillance has increased significantly, particularly among older patients with limited life expectancy, raising concern for possible overuse.
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Eliminating Defects in Value: Turnaround of an MSSP ACOA health system transformational leadership framework and management system made visible and eliminated defects in value and was associated with reduced annual Medicare expenditures and increased quality between 2017 and 2020.
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Challenges of Fracture Risk Assessment in Asian and Black WomenDifferences in bone density and FRAX fracture risk scores among Black and Asian women yield greater discordance in fracture risk estimation compared with White women.
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Value-Based Care Through Postacute Home Health Under CMS PACT RegulationsAmong a patient population defined by CMS postacute care transfer regulations, home health vs no postacute care was associated with reduced 30-day readmissions and costs.
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Potential Impact of Hospital at Home on Postoperative ReadmissionsMany postoperative readmissions are amenable to diversion to a hospital at home program for surgical patients, representing an opportunity to generate revenue and improve patient experience.
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Association of Wound Healing With Quality and Continuity of Care and Sociodemographic CharacteristicsBased on the analysis of electronic health records from 480 clinics, we found that better care quality and continuity are associated with better-than-expected wound healing performance.
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Coordination Without Consolidation? Options for ACOsFindings published in this issue add to the growing literature showing that multiple types of accountable care organizations (ACOs) can be successful, whether they are confederations of smaller, independent primary care practices or larger, integrated systems.
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Contemporary Care Patterns in the Management of Small Renal MassesAn investigation of management patterns after initial radiographic diagnosis of small renal masses showed that early urologist referral was associated with guideline-concordant care.
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New Research Further Supports Use of Financial Navigators in Myeloma CarePatients with multiple myeloma are living longer; therefore, their lifelong treatment expenses can become burdensome.
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How Medicare Advantage Plans Use Data for Supplemental Benefits Decision-MakingThis article presents findings from interviews conducted with executives from 29 Medicare Advantage plans regarding plan decision-making processes related to new social risk factor–related benefits.
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The Impact of 1-Star Physician Ratings on New Patient VolumeAnalysis of a single-specialty practice’s scheduled appointments and reviews of physicians finds that 1-star ratings have a limited but longitudinal influence on new patient volume.
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Telehealth Transitional Care and 30-Day Readmission During the COVID-19 PandemicThis study found that the dramatic shift from face-to-face posthospital transitional care to telehealth did not affect 30-day readmission or mortality during the COVID-19 pandemic.
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Intensive Care Management of a Complex Medicaid Population: A Randomized EvaluationThe authors present findings of a randomized evaluation of Medicaid patients at an academic medical center, which found that intensive care management was associated with reduced total medical expense.
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Have Racial Disparities in Home Dialysis Utilization Changed Over Time?Medicare prospective payment for dialysis modestly increased availability and use of home-based dialysis treatment but did not affect historic racial disparities in home dialysis.
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Hands Down, COVID-19 Will Change Medical PracticeCoronavirus disease 2019 (COVID-19) has challenged us to incorporate technology into engaging, interacting with, and caring for patients, using televisits and video conferencing in ways that have previously been resisted or derided.
