Home administration of oral paclitaxel and encequidar is associated with potential cost savings for payers compared with clinic administration of intravenous chemotherapy in metastatic breast cancer patients.
This study identified inefficiencies in drug and medical service utilization related to pain management among Medicare members with osteoarthritis and chronic low back pain.
Analysis of spending differences among accountable care organizations (ACOs) may help identify cost savings opportunities. We examined the magnitude and sources of spending variation among ACOs over 4 years.
This study describes reasons for nonparticipation in type 2 diabetes mellitus education and identifies typical subgroups of nonparticipants in order to improve recruitment strategies.
Patients with higher out-of-pocket visit costs, such as co-payments and deductibles, initiated provider contact by e-mail more often. Patients report that e-mailing changed their care-seeking behaviors and improved overall health.
Evaluating the impact of a high-touch primary care model among a Medicare Advantage population in comparison with a standard practice–based model. Check out our website’s new table/figure pop-up feature! Click on the name of a table or figure in the text to see it in your browser.
It is important to take into account individual complexities such as comorbidities and pill burden when selecting antiretroviral therapy regimens for individuals living with HIV.
The authors developed a weighted quality measure to reflect the total health benefit conferred by a health plan annually to its members.
Premiums in federally facilitated Affordable Care Act Health Insurance Marketplaces are higher in geographic areas with more concentrated hospitals and physician practices and fewer insurers.
As increasing numbers of children with special healthcare needs move into Medicaid managed care, health plans can improve care coordination using evidence from Medicare.
Physician-specific, aggregate patient medication adherence data vary significantly and provide an expanded focus for interventions to improve patient adherence to treatment.
Outpatient surgeries in the United States account for roughly 7% of annual healthcare expenditures. To exploit substantial opportunities to improve the value of outpatient surgical care, the authors composed an evidence-based care delivery composite for national discussion and pilot testing.
Expansion of episode of care measurement models to include presurgical care is an added opportunity to improve quality, value, and efficiency in healthcare delivery.
Glycemic control in patients with type 2 diabetes was improved through a shared medical appointment program focusing on lifestyle education and behavior change.
Analysis of 77,462 family practice providers showed large regional differences in types of procedures performed, and significant differences in submitted charges and payments, across regions.
A decision-analytic model was used to estimate cost-effectiveness of adopting a 21-gene assay in treatment decisions for women with early-stage N (1-3)/ER HER2-negative breast cancer.
Four large Medicare Advantage insurers manage access to expensive physician-administered drugs with a combination of prior authorization, step therapy, and Part D formulary design.