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Financial Incentives Tied to Medicare Star Ratings: Impact on Influenza Vaccination Uptake in Medicare BeneficiariesInfluenza vaccine uptake improved among Medicare Advantage enrollees when influenza vaccination was introduced as a performance metric in Medicare star ratings and accompanying bonus payments.
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Thoughts on Redesigning Health Care: Aligning Incentives to Drive InnovationAn editorial in response to the editor-in-chief’s December 2021 letter describes how a payer continues to push the limits of innovation through shared learnings and collaboration.
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An Accelerated Hospital Observation Pathway to Reduce Length of Stay for Patients With COVID-19For select patients hospitalized due to COVID-19, an academic urban hospital implemented an observation pathway that incorporated mobile health technology, reducing hospital length of stay by more than 2 days.
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Care Management Improves Total Cost of Care for Patients With DementiaCompared with usual care, a dementia care management program improved various cost of care and utilization metrics in a Medicare managed care population at 12 months.
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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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Inpatient Opioid Receipt and Care Experiences for Vaginal DeliveryThe objective of this study was to examine the relationship between inpatient opioid receipt and care experiences of women hospitalized for vaginal delivery.
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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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To Preserve Access to Care, Congress Must Repair Medicare’s Broken Payment SystemThe author, chair of the Government Affairs Committee with the American College of Rheumatology, calls for support for efforts in Congress to reform the Physician Fee Schedule.
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Telehealth Transitional Care and 30-Day Readmission During the COVID-19 PandemicThis 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.
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Private Label BiosimilarsThe expert panel discusses the greater potential for private label biosimilars.
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Assessment of Structured Data Elements for Social Risk FactorsAn expert panel identified and assessed electronic health record and health information exchange structured data elements to support future development of social risk factor computable phenotyping.
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Managed Care COVID-19 Outcomes in a Population Health ProgramData from 38,193 patients showed that managed care patients have COVID-19 risk factors similar to those of the general population and that a population health program decreased mortality.
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Primary Care Referrals to Nephrology in Patients With Advanced Kidney DiseasePrimary care physicians did not refer the majority of patients with severe nephropathy to specialists; nonreferred patients had fewer comorbidities and might be better kidney transplant candidates.
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Measuring Continuity of Care for Diabetes: Which Visits to Include?This study examined how inclusion of different provider specialties affected Continuity of Care Index values, year-to-year stability, and association with emergency department visits.
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Egg Donors and Recipients With PCOSNo difference was shown regarding pregnancy and childbirth outcomes among patients with polycystic ovary syndrome (PCOS) who receive oocytes from women with or without PCOS.
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Understanding Suboptimal e-Consult Requests: Lessons From the VAUS Department of Veterans Affairs (VA) clinicians’ perspectives on what constitutes a good e-consult and why suboptimal e-consult requests occur contain broadly applicable lessons for other health systems.
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Assessment of Structured Data Elements for Social Risk FactorsAn expert panel identified and assessed electronic health record and health information exchange structured data elements to support future development of social risk factor computable phenotyping.
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The Promising Future of Alzheimer Disease TreatmentPanelists conclude the discussion with personal insight into the promising future of Alzheimer disease treatment.
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Reduced Medical Spending Associated With Integrated Pharmacy BenefitsMembers covered by an integrated pharmacy benefit (as opposed to a pharmacy carve-out) experienced slower growth in medical spending.
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A Multistakeholder Effort in Pennsylvania to Improve the Accuracy of Reporting Fatal Drug OverdosesThe authors describe a novel training program for death certifiers in Pennsylvania, which has been designed to specifically focus on some of the main challenges in the death certification process and resulted in a useful model that can potentially be adopted by other states or municipalities.
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Care for Food-Insecure Enrollees in Medicare Advantage vs Traditional MedicareMedicare Advantage plans may deliver care more efficiently to food-insecure beneficiaries than traditional Medicare, but they are not better at reducing food insecurity.
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Impact of COVID-19 Pandemic on Accessibility of Taiwanese Medical CareThe COVID-19 pandemic disrupted access to routine medical care in community populations in Taiwan. The unmet needs should be emphasized as normal life resumes.
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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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Mental Health Concerns Prevalent in Patients With AD, Poster SaysA new study presented at this year’s American College of Allergy, Asthma and Immunology Annual Scientific Meeting highlights the need for mental health support in patients with atopic dermatitis (AD).
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Pediatric Oral Health Services in Medicaid Managed Care and Fee for ServiceRates of preventive oral health services among pediatric medical visits in Florida were similar whether visits were paid via Medicaid comprehensive managed care or fee for service.
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How Medicare Advantage Plans Use Data for Supplemental Benefits Decision-MakingThis 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.
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The Impact of Nurse Practitioner Attribution in Medicare Shared Savings ACOsAllowing nurse practitioners to serve as attribution-eligible providers for Medicare Shared Savings Program accountable care organizations leads to no change in hierarchical condition category risk scores and modest growth in attributed beneficiaries.
