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Project ECHO: An Effective Means of Increasing Palliative Care CapacityThis article provides insight on the work of 7 of Project ECHO’s replicating partners from around the world who are implementing the ECHO model to address the knowledge gap that underlies integrated palliative care crisis.
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Does Telephone Care Management Help Medicaid Beneficiaries With Depression?Telephone care management increased mental health service use for Medicaid beneficiaries with depression but did not reduce depression severity. More intensive services may be needed.
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Lowering Copayments: Impact of Simvastatin Patent Expiration on Patient AdherenceDecreasing statin copayments because of the patent expiration of simvastatin has led to moderate increases in therapy adherence.
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Patients' Views on Price Shopping and Price TransparencyThe authors interviewed patients with access to a price transparency website. Despite a positive opinion of price shopping in theory, respondents reported barriers to doing so in reality.
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Out-of-Plan Pharmacy Use: Insights Into Patient BehaviorPrescription cost and pharmacy convenience were identified as the most significant drivers of out-of-plan pharmacy use.
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The Ingredients of Success in a Medicare Accountable Care OrganizationFor 2 successive years, the Hackensack Alliance Accountable Care Organization achieved cost savings and maintained quality by using physicians with patient-centered medical homes and nurse care coordinators focused on high-risk patients.
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False Activation of the Cardiac Catheterization Laboratory for Primary PCIBetween 2005 and 2011, rates of cardiac catheterization laboratory false activation doubled while mean door-to-balloon times for primary PCI declined.
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Medicare Beneficiaries’ Out-of-Pocket Costs for Commonly Used Generic Drugs, 2009-2017Out-of-pocket costs required by Medicare prescription drug plans for drugs available through Walmart’s generic drug discount program have decreased from 2009 to 2017.
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Factors of Hyperlipidemia Medication Adherence in a Nationwide Health PlanMedication adherence in hyperlipidemia remains poor on a nationally representative level. Predictors of medication adherence from a nationally representative commercial health plan are reported.
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Forward-Thinking Insurers Adopt Genomics, Medicare Makes Perilous, Costly Leap BackwardAuthors from My Gene Counsel discuss gaps in CMS reimbursement policy for genetic testing and counseling, in light of advances in guidelines from groups that include the National Comprehensive Cancer Network.
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Insurers’ Perspectives on MA Value-Based Insurance Design ModelThis article describes perspectives of Medicare Advantage (MA) insurers about participating in the CMS value-based insurance design model test launched in 2017.
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HITECH Spurs EHR Vendor Competition and Innovation, Resulting in Increased AdoptionThis is the first empirical evidence to demonstrate increased competition and innovation in the EHR industry as a result of the HITECH program.
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Finally: CMS to Address Allowing Hospitals More Say in Selecting Post Acute Care ProvidersHospital CEO and former SNF administrator, Dr Josh Luke, who founded the National Readmission Prevention Collaborative, discusses MEDPAC's recommendation to CMS that anti-steering regulations for hospitals be done away with.
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Thirty-Day Readmissions: Relationship to Physician Attending Type and Social ConnectednessThis study examined patient clinical and demographic characteristics, healthcare system factors, and patients’ experiences of care associated with 30-day readmissions in a hospital with a Pioneer Accountable Care Organization.
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Cost Comparison of Peritoneal Dialysis Versus Hemodialysis in End-Stage Renal DiseasePatients with end-stage renal disease who began peritoneal dialysis had lower 1-year hospitalization rates and lower total healthcare costs than those who began therapy with hemodialysis.
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Behavioral Health Disorders and Adherence to Measures of Diabetes Care QualityPersons with substance use disorders were less likely and persons with schizophrenia/paranoia were more likely to be adherent to measures of diabetes care quality.
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Leveraging Remote Behavioral Health Interventions to Improve Medical Outcomes and Reduce CostsSuccessful patient engagement in a nationally available, remotely delivered behavioral health intervention can significantly improve medical outcomes and lower healthcare costs.
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Payer—Provider Patient Registry Utilized in a Behavioral Health HomeA payer—provider, patient registry to identify individuals with serious mental illness and chronic physical health conditions for utilization in behavioral health homes is described.
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Patient-Reported Denials, Appeals, and Complaints: Associations With Overall Plan RatingsPatient ratings of plans and care were lower among beneficiaries filing complaints or reporting denied care. Appeals did not further predict ratings, but successful complaint resolution did.
