Authors
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Part D Beneficiaries’ Incentives and Responses Under Preferred Pharmacy NetworksUnder preferred pharmacy networks, unsubsidized Part D beneficiaries faced substantial incentives and moderately switched toward preferred pharmacies, whereas subsidized beneficiaries were insulated and demonstrated little switching.
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Health Systems and Telemedicine Adoption for Diabetes and Hypertension CareSmall practices reduced their use of telemedicine during early stages of the COVID-19 pandemic. Technical support may help expand and maintain telemedicine in small practices.
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Contributor: North Carolinians Worked Together to Enact Medicaid Expansion. Our Collaboration Can’t End Now.The sustained, collaborative effort to expand Medicaid will improve the lives of working North Carolinians who, prior to enactment, earned too much to qualify for Medicaid, but not enough to afford insurance on the marketplace.
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Incorporating Health IT Into Primary Care TransformationLongitudinal evaluation of an advanced primary care reform effort found some improvements in health information technology (IT) offerings and use as well as opportunities to improve future collaboration.
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Trends in Medicare Part D Coverage of Generics With Equivalent Brand-Name DrugsHigh-tier generic drug placement in Medicare Part D has increased over time, but it may be related to a drug’s clinical profile and availability of substitutes rather than preferred brand-name drug coverage.
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Traditional Medicare Supplemental Insurance and the Rise of Medicare AdvantageRising Medicare Advantage enrollment occurred alongside declines in enrollment in traditional Medicare with employer-sponsored supplemental coverage and traditional Medicare without supplemental coverage.
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Contributor: It’s About Time to Realize the Full Potential of Data in Health CarePromoting health equity isn’t only about consideration of underlying health risks; it’s also about using that data to inform population care as well as give clinicians and their teams more time with the patient in front of them.
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Unfulfilled Home Health Referrals Lead to Higher Mortality Among Medicare Advantage MembersMedicare Advantage members referred to home health after acute hospitalization who did not receive home health services had higher mortality at 30, 90, and 180 days.
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Safety vs Price in the Generic Drug Market: MetforminThe generic drug market focuses on price. However, multiple generic metformin drugs have been recalled due to poor drug quality. The authors examine price and quality after these recalls.
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Patient Satisfaction With Letter-Based Communication of LCS Pulmonary Nodule ResultsPatients were satisfied with receiving their lung cancer screening (LCS) pulmonary nodule results via letter and considered the amount of information provided in the letter appropriate.
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Harnessing AI for Population Health: A Call to Action for Policy Makers and Health Care LeadersThe authors detail how artificial intelligence could be used in primary, secondary, and tertiary prevention to improve health outcomes and provide better value-based care.
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Private Label BiosimilarsThe expert panel discusses the greater potential for private label biosimilars.
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A Cue-to-Action Pilot Project to Increase Screening MammographyA targeted cue-to-action campaign of outreach, education, and incentive can improve uptake of screening mammography.
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An Analysis of Medicare Accountable Care Organization Expense ReportsThe authors of this study examined expense reports to understand how participants in Medicare’s Accountable Care Organization Investment Model spent to achieve program goals.
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Clinical Profile of COVID-19 Infection in Postvaccination IndividualsThis article describes the findings of an observational study carried out in India to examine the clinical profile of individuals detected to be COVID-19 positive post vaccination.
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Primary Care Video and Telephone Telemedicine During the COVID-19 Pandemic: Treatment and Follow-up Health Care UtilizationTelephone visits may offer a simple and convenient option to address patient primary care needs without raising safety concerns.
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Concluding Remarks: Impact of Alzheimer Disease, Promising Treatments in Development, and Future OutlookLooking to the future of Alzheimer disease treatment, the panel discusses key takeaways on the evolving therapeutic landscape.
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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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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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Baloxavir vs Oseltamivir: Reduced Utilization and Costs in InfluenzaBaloxavir, compared with oseltamivir, was associated with lower health care resource utilization and costs in patients with influenza, particularly those at high risk of secondary complications.
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Differences in Savings and Quality by Type of ACO Model2016-2018 Next Generation Accountable Care Organization (ACO) and Medicare Shared Savings Program cost and quality data show similar performance, suggesting that increasing financial risk to health systems may not affect performance.
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Impact of Food Affordability on Diabetes-Related Preventable HospitalizationMedicaid enrollees residing in counties with greater food affordability had lower odds of preventable hospitalization related to diabetes.
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Estimating the Economic Burden of Migraine on US EmployersThe Migraine Impact Model is an interactive calculator that estimates migraine prevalence within a workforce and the associated economic burden of migraine on the employer.
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The Implementation of Opioid Prescribing Report Cards in Medicaid Managed Care: A Community Quality CollaborativeThis article describes the Philadelphia Medicaid Opioid Prescribing Initiative that was launched by a multidisciplinary team and mailed local Medicaid providers individualized prescribing report cards.
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Integrating Third-Party Apps With Electronic Health Records to Support COVID-19 ResponseThis study observed a rapid increase in the integration of telehealth- and COVID-19–related apps with electronic health records during the COVID-19 pandemic.
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Hospital Discharge Diagnosis Position: Impact on Adult Pneumonia Burden EstimatesDisease burden estimates of pneumonia-associated hospitalizations are more sensitive when including pneumonia coded in any diagnosis field vs in only the first discharge diagnosis field.
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Improving Risk Stratification Using AI and Social Determinants of HealthPrediction models combining claims data with social determinants of health and additional, more-timely data sources using artificial intelligence (AI) can better identify individuals with the highest future medical spending.
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Contributor: Why Hasn’t Value-Based Care Delivered on Its Promise at Scale?To deliver on the promise of value-based care, organizations need to return to the fundamental objective: to deliver high-quality, affordable care to our communities.
