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It's Time for CMS to Utilize Functional Assessment as a Key Quality ComponentThis editorial reviews the recently published study (AJMC April) by Gerrard et al, which analyzed the statistical prediction model of the Fitness Index Measure for hospital readmission in unilateral hip fractures.
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Using Applied Machine Learning to Predict Healthcare Utilization Based on Socioeconomic Determinants of CareThis study demonstrates that it is possible to generate a highly accurate model to predict inpatient and emergency department utilization using data on socioeconomic determinants of care.
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A Predictive Model of Hospitalization Risk Among Disabled Medicaid EnrolleesPredictive modeling can be used to identify disabled Medicaid beneficiaries at high risk of future hospitalizations who could benefit from appropriate interventions.
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High-Impact Workflow Changes for Value-Based Care SuccessAs oncology practices transition to value-based care, they are challenged to take on more holistic responsibility for their patient. Fortunately, the examples of practices participating in CMS’ Oncology Care Model can offer valuable insight into the most impactful workflow changes providers can implement as they strive to achieve cost and quality improvements.
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Economic Value of Transcatheter Valve Replacement for Inoperable Aortic StenosisTranscatheter aortic valve replacement for inoperable severe, symptomatic aortic stenosis will create significant social value in the next decade, mostly accruing to patients versus manufacturers.
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Tacking Upwind: Reducing Spending Among High-risk Commercially Insured PatientsAlthough commercial accountable care organization populations are healthy on average, some individuals might benefit from programs for high-risk patients to mitigate high levels of health care utilization.
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E-Consult Implementation: Lessons Learned Using Consolidated Framework for Implementation ResearchThis paper identified 4 factors associated with implementation success of e-consults in 8 VA medical centers, with implications for implementing similar health IT initiatives elsewhere.
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Adherence to Statins and LDL-Cholesterol Goal AttainmentThis study examined adherence to statins and low-density lipoprotein cholesterol goal attainment in patients with coronary artery disease.
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Barriers to Transition of Obese Patients From Hospital to CommunityThis study explored barriers to the transition of obese patients from hospital to community as perceived by case managers, nursing home directors, and home health directors.
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Systolic Blood Pressure Control After Participation in a Hypertension Intervention StudySystolic blood pressure control was not maintained in a large proportion of patients after the end of participation in a hypertension intervention study.
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Impact of a Managed Controlled-Opioid Prescription Monitoring Program on Care CoordinationManaged care organizations have the opportunity to identify potential opioid misuse and implement care coordination interventions, which can enhance safety and streamline patient pain management.
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Insurance Coverage and Diabetes Quality Indicators Among Patients in NHANESIn a National Health and Nutrition Examination Survey secondary analysis, privately and publicly insured patients with diabetes were both more likely to meet quality indicators than the uninsured.
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The Hidden Costs of Moving Care HomeAs home-based care utilization rises, an exploration of potential unintended consequences is necessary. The authors focus on support gaps, informal caregiving, and failure to meaningfully engage clinicians.
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Patient Participation in Care Management: Are They Aware?Many patients offered, and those already participating in, care management are unaware of what care management is and that they have participated.
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Attributes Common to Programs That Successfully Treat High-Need, High-Cost IndividualsMany programs attempting to effectively treat high-need, high-cost individuals have not been able to lower spending, improve outcomes, or increase satisfaction. This paper suggests 8 attributes that many successful programs share.
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Is There a Mathematical Resolution to the Cost-Versus-Value Debate?Solutions proposed by patient advocates and physicians to control costs provide approaches to valuing new drug/treatments compared with 1 or several prevailing standards of care. Increasingly, however, the debate over cost is transitioning to a debate over value.
