Authors

Reimbursement for Genetic Variant Reinterpretation: Five Questions Payers Should Ask

Periodic reinterpretation of genetic sequencing results presents a challenge for developing transparent and systematic coverage and reimbursement policies.

Contributor: The Connection Between Gout and CVD Requires Cross-Specialty Collaboration

The 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.

Telehealth User Experiences During COVID-19: A Case Study of Outpatient Cardiovascular Clinics Affiliated With a Large Academic Practice

In 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.

Proactive Care Management of AI-Identified At-Risk Patients Decreases Preventable Admissions

Proactive care management for artificial intelligence (AI)–identified at-risk patients reduced potentially preventable hospital admissions.

To Report or Not Report Health Care Data Breaches

This 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.

Pharmacist Hypertension Management Using an Electronic Health Record–Based Approach

The authors studied the impact of a pharmacist intervention on blood pressure control compared with usual care.

Rising Use of Surveillance Colonoscopy and Potential Impacts

The proportion of colonoscopies performed for postpolypectomy surveillance has increased significantly, particularly among older patients with limited life expectancy, raising concern for possible overuse.

Association of the MedWise Risk Score With Health Care Outcomes

Tracking the Performance, Challenges, and Evolution of Value-Based Contracts: Neha Kashalikar, PharmD

Neha Kashalikar, PharmD, director of strategic pharmacy consulting at MassHealth, breaks down the outcome measures often used in pharmacy and medical claims to evaluate the performance of value-based contracts.

Challenges of Fracture Risk Assessment in Asian and Black Women

Differences in bone density and FRAX fracture risk scores among Black and Asian women yield greater discordance in fracture risk estimation compared with White women.

A Health Economic Evaluation of Digital Digestive Care Management

Chronic gastrointestinal disorders are common and costly for employers. Use of a digital digestive care program was associated with reduced health care spending.

“Expanding Access Isn’t Just About Fairness—It’s About Building Better Treatments for Everyone”

Regina Barragan-Carrillo, MD, a postdoctoral fellow at City of Hope Comprehensive Cancer Center, discussed findings that show 76% of renal cell carcinoma trials take place in wealthy countries, amid news that clinical trial access for the world's poor may become even more challenging.

Value-Based Care Through Postacute Home Health Under CMS PACT Regulations

Among 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.

Potential Impact of Hospital at Home on Postoperative Readmissions

Many 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.

Association of Wound Healing With Quality and Continuity of Care and Sociodemographic Characteristics

Based 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.

Medicare Expenditures in the First Year of Amyotrophic Lateral Sclerosis Diagnosis

Medicare expenditures for patients with amyotrophic lateral sclerosis are more than 3 times those of the average Medicare beneficiary, and drug therapies are an important cost driver.

Coordination Without Consolidation? Options for ACOs

Findings 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.

Contemporary Care Patterns in the Management of Small Renal Masses

An investigation of management patterns after initial radiographic diagnosis of small renal masses showed that early urologist referral was associated with guideline-concordant care.

New Research Further Supports Use of Financial Navigators in Myeloma Care

Patients with multiple myeloma are living longer; therefore, their lifelong treatment expenses can become burdensome.

How Medicare Advantage Plans Use Data for Supplemental Benefits Decision-Making

This 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.

The Impact of 1-Star Physician Ratings on New Patient Volume

Analysis 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.

Telehealth Transitional Care and 30-Day Readmission During the COVID-19 Pandemic

This 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.

Intensive Care Management of a Complex Medicaid Population: A Randomized Evaluation

The 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.

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.

Hands Down, COVID-19 Will Change Medical Practice

Coronavirus 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.

Access to Consultative Dermatologic Care via Physician-to-Physician Asynchronous Outpatient Teledermatology

Direct access of primary care physicians to dermatologists via asynchronous teledermatology improves a health system’s ability to increase patient access to dermatologic care.

Operating Room Efficiency of Orthopedic Surgery During the COVID-19 Era

The authors analyzed the impacts of COVID-19 on orthopedic operating room efficiency via comparison of 14,856 surgeries performed before, during, and after the pandemic.

Challenges With Implementing the Diabetes Prevention Program for Medicare Beneficiaries in an Integrated Health System

This study presents challenges of implementing the CDC-approved Diabetes Prevention Program for Medicare beneficiaries at a large, integrated health care delivery system.

Predictors of Discharge From the VA Caregiver Support Program

The year of application predicts discharge from the Department of Veterans Affairs (VA) caregiver program. Unexpected, disallowed criteria also predict discharge, with significant others facing higher discharge risk than spouses.

Service Line Care Delivery Model for COVID-19 Patient-Centric Care

The authors provide steps hospitals can take to align their care delivery model to effectively meet the demands of a public health crisis such as the current pandemic.