Authors
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A Pay-for-Performance Program for Diabetes Care in Taiwan: A Preliminary AssessmentA pay-for-performance program in Taiwan improved the quality of diabetes care and slightly increased the cost of care.
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Cost-Effectiveness of Medicare Drug Plans in Schizophrenia and Bipolar DisorderIn Medicare Part D, generic drug coverage was cost saving compared with no coverage in bipolar disorder and schizophrenia while improving health outcomes.
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Medication, Diagnostic, and Cost Information as Predictors of High-Risk Patients in Need of Care ManagementPredictive models from diagnostic or medication data identify care management candidates who are more amenable to clinical interventions than groups identified using prior cost alone.
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The Relationship Between Adherence and Total Spending Among Medicare Beneficiaries With Type 2 DiabetesThis study describes a widespread variation in medication adherence, pharmacy cost sharing, and medical spending. Increased cost sharing may decrease adherence and increase total diabetes spending.
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Value-Based Payment in Implementing Evidence-Based Care: The Mental Health Integration Program in Washington StateValue-based payment improved fidelity to key elements of the Collaborative Care Model—an evidence-based mental health intervention—and improved patient depression outcomes in Washington state.
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Forgotten Patients: ACO Attribution Omits Those With Low Service Use and the DyingThis article compares clinical and utilization profiles of Medicare patients who are attributed to provider groups with those of patients unattributed to any provider group in accountable care organization models.
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Technology-Driven Intervention to Improve Hypertension Outcomes in Community Health CentersHealth information technology that is implemented as part of a multifaceted quality improvement initiative can lead to improvements in hypertension care and outcomes.
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Association Among Change in Medical Costs, Level of Comorbidity, and Change in Adherence BehaviorThe authors found that comorbidity burden and the direction of behavioral change influence the relationship between adherence and medical spend. This could affect the cost-benefit considerations of medication adherence programs.
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Impact of Functional Recovery on Patients Having Heart SurgeryThis article describes the positive impact that actively managing functional recovery has on postacute placement for patients undergoing coronary artery bypass surgery.
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How Comorbidities and Preoperative Expenditures Correlate With Postoperative Adverse OutcomesAdjusting for patients' covariates, postoperative complications and mortality among geriatric surgical patients exhibited an age-dependent, illness-related, and preoperative medical expense“associated pattern under universal healthcare coverage.
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Value-Based Contracting Innovated Medicare Advantage Healthcare Delivery and Improved SurvivalElderly Medicare Advantage members with multiple chronic conditions attained a survival benefit from more cost-effective care when a private plan developed gainshare and monetary risk-bearing arrangements with its contracted providers.
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“Lean” Improvement in the Quality of Patient Care in the Hospital Admissions ProcessThe objective of this work is to improve the quality of patient care in the admission office service of the University Hospital Virgen del Rocío (HUVR) by standardizing and systematizing its procedures using Lean methodology. The results have allowed HUVR to achieve continuous improvement in the process, eliminating the elements that do not add value.
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Helping Cancer Patients and Caregivers Navigate Immunotherapy TreatmentPatients, caregivers, and providers need education on immunotherapy treatment, support in patient-provider communications as well as support in mitigating the financial impact of immunotherapy treatment.
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Primary Care Physician Resource Use Changes Associated With Feedback ReportsImplementing systemwide dissemination of feedback reports to primary care physicians in an integrated delivery system may be associated with changes in medical resource use.
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Disease Management Programs in Type 2 Diabetes: Quality of CareDisease management programs for diabetes can improve some processes of care, but they do not improve intermediate outcomes beyond doubt.
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Artificial Intelligence in Medicare: Utilization, Spending, and Access to AI-Enabled Clinical SoftwareThis study quantified the trends over time in utilization of, spending on, and access to CT fractional flow reserve, the first artificial intelligence (AI)–enabled clinical software reimbursed by Medicare.
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Quality of Anticoagulation Control Among Patients With Atrial FibrillationPatients with atrial fibrillation receiving routine medical care within a large managed care organization were found to have suboptimal anticoagulation control.
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What Performance Measures Do Consumers Find Useful When Selecting Marketplace Health Plans?Marketplace consumers desire more health plan measures on how well plans support long-term patient—physician relationships. Consumers are skeptical of measures about rewarding providers for high quality.
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Why Accounting for Our Differences Matter in Assessing Drug ValueThe authors discuss how more efforts need to ensure the methods used to measure the “value” of new therapies include factors that reflect patient heterogeneity.
