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Diabetes Educators in Accountable Care Organizations: Meeting Quality Measures Through Diabetes Self-Management Education and Care CoordinationDiabetes educators are well-positioned to help accountable care organizations meet their business, healthcare, and financial goals. The emphasis on primary care in treating chronic disease calls for an increased emphasis on diabetes educators to achieve better healthcare outcomes in a cost-effective manner.
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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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Beyond Regulatory Requirements: Designing ACO Websites to Enhance Stakeholder EngagementThe authors describe best practices for Web design in the accountable care organization space in order to enhance engagement with patients and providers.
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HCV Screening Practices and Prevalence in an MCO, 2000-2007HCV screening and prevalence estimates, unadjusted and adjusted for HCV risk factors, are examined in this 8-year observational study of a managed care organization.
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Impact of an Online Prescription Management Account on Medication AdherenceOnline prescription management accounts may help promote medication adherence, as utilizing patients had a higher proportion of days covered than nonusers.
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Patient Attribution: Why the Method MattersReliable identification of the physician–patient relationship is necessary for accurate evaluation. Standardization of evidence-based attribution methods is essential to improve the value of healthcare.
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Two-Sided Risk in the Oncology Care ModelThe US healthcare system remains one of the most inefficient healthcare systems in the world. The Bloomberg Health-Care Efficiency Index ranked the United States 54th among 56 countries in 2018, tied with Azerbaijan and only ahead of Bulgaria. This occurs even though the United States spends $10,244 per capita annually on healthcare, a figure representing 17% of the gross domestic product.
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How to Save the US Health Care System From a Complete CollapseThere are 3 ways to make the US health care system more efficient and sustainable: address its burdensome complexity, emphasize primary care reimbursement, and regulate drug pricing.
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Provider Differences in Biosimilar Uptake in the Filgrastim MarketThe speed and extent of biosimilar penetration differ across provider types. Provider awareness and incentives are significantly associated with biosimilar uptake.
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Patients' Views of a Behavioral Intervention Including Financial IncentivesPatients who enrolled in a trial to lower low-density lipoprotein cholesterol spoke positively of the multifaceted intervention: pillbox monitoring and financial incentives were socially acceptable.
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Community Pharmacy Automatic Refill Program Improves Adherence to Maintenance Therapy and Reduces Wasted MedicationEvaluation of a national retail pharmacy automatic refill program for patients on medication for chronic disease demonstrated significantly improved patient adherence and reduced medication oversupply.
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Retail Clinic Utilization Associated With Lower Total Cost of CareRetail clinic use is associated with lower overall total cost of care based on a matched-pair analysis.
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Changes in Ambulatory Utilization After Switching From Medicaid Fee-for-Service to Managed CareTransitioning from Medicaid fee-for-service to Medicaid managed care was associated with a significant decrease in ambulatory utilization, especially among beneficiaries with 5 or more chronic conditions.
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A Gray Area for Reimbursement: Medical Foods for Non–Inborn Errors of MetabolismMost non–inborn errors of metabolism (non-IEM) medical foods (MFs) do not meet the regulatory MF definition and lack scientific evidence for safety and efficacy. Non-IEM MFs are not yet ready for reimbursement by public insurers.
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Does Comparing Cesarean Delivery Rates Influence Women’s Choice of Obstetric Hospital?This randomized controlled trial finds that a hospital cesarean delivery rate comparison tool affects women’s perceptions but not where they choose to deliver.
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Fragmented Ambulatory Care and Subsequent Emergency Department Visits and Hospital Admissions Among Medicaid BeneficiariesAmong Medicaid beneficiaries, having more fragmented ambulatory care was associated with a modest independent increase in the hazard of a subsequent emergency department visit.
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Bowling Alone, Healing Together: The Role of Social Capital in Delivery ReformAs delivery reform unfolds and leads to new models of care delivery, social capital will be a powerful concept to incorporate into their design and evaluation.
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Performance of the Adapted Diabetes Complications Severity Index Translated to ICD-10We present an International Classification of Diseases, Tenth Revision (ICD-10) translation of the adapted Diabetes Complications Severity Index and show its performance in predicting hospitalizations, mortality, and healthcare-associated costs.
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Enhancing Dementia Care Through Digital HealthThere is ample opportunity to integrate digital health technologies into dementia care to promote independent living and prevent unnecessary healthcare utilization.
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Patient-Centered Medical Homes and Preventive Service UsePreventive service use was better in patients with a usual source of care but little improved by patient-centered medical home status.
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Perceptions of the Medical Home by Parents of Children With Chronic IllnessesThis article compares how parents of children seeking specialty care perceive National Committee for Quality Assurance—based patient-centered medical home elements in the primary and specialty care settings.
