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Economics of a Health System’s Direct-to-Consumer Telemedicine for Its EmployeesA direct-to-consumer telemedicine service resulted in lower per-episode unit costs for care within 7 days and only marginally increased the use of services overall.
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Service Line Care Delivery Model for COVID-19 Patient-Centric CareThe authors provide steps hospitals can take to align their care delivery model to effectively meet the demands of a public health crisis such as the current pandemic.
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More Than “Beating the Benchmark”: 5 Medicare ACOs, 2015-2019This retrospective cohort study compared the results of 5 Medicare Shared Savings Program accountable care organizations (ACOs) vs both ACO benchmarks and regional comparators over 4 years.
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Effective Prevention and Management of COVID-19 in Outpatient Hemodialysis PatientsThe authors introduce a mobile phone app that may effectively prevent and manage coronavirus disease 2019 (COVID-19) in outpatient hemodialysis patients in Sichuan Province, China.
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Economics of a Health System’s Direct-to-Consumer Telemedicine for Its EmployeesA direct-to-consumer telemedicine service resulted in lower per-episode unit costs for care within 7 days and only marginally increased the use of services overall.
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Impact of Expanded Carrier Screening on Health Care UtilizationThis study shows little evidence of harms or increased health care utilization for people receiving negative (normal) results of expanded carrier screening through genome sequencing.
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Dallas Nephrology Associates’ Journey to Value-Based CarePreventing or delaying the onset of end-stage kidney disease is vital. By implementing a results-driven, value-based approach, Dallas Nephrology Associates has demonstrated improved patient outcomes and value for payers.
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Insurance Payer Is Associated With Length of Stay After Traumatic Brain InjuryAmong hospitalized patients with traumatic brain injury, Medicaid fee-for-service was associated with longer hospital stays than private insurance and Medicaid managed care organizations.
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Health Care Resource Utilization, Quality Metrics, and Costs of Bladder Cancer Within the Oncology Care ModelSpending on novel therapies in high-risk bladder cancer had minimal impact on Oncology Care Model payments to practices, according to this cohort study and an average performance estimation.
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A “Sludge Audit” for Health System Colorectal Cancer Screening ServicesA systematic, mixed methods “sludge audit” identified novel health system delivery targets for improving colorectal cancer screening services.
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Accountable Care Organizations and HPV Vaccine Uptake: A Multilevel AnalysisThe authors evaluated whether adolescents receiving care at accountable care organizations (ACOs) vs non-ACOs were more likely to initiate and complete the human papillomavirus (HPV) vaccination series.
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A Standardized Care Pathway Increases Optimal Dialysis StartsThe authors observed a significant increase in optimal starts for dialysis and in peritoneal dialysis rates after implementing a standardized end-stage renal disease transition pathway.
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CAAP Rule and Prescription Drug PricesThis article describes a recently finalized CMS rule addressing the permissibility of co-pay accumulator adjustment programs (CAAPs) when no generic is available.
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Cost-effectiveness of a 3-Year Tele-Messaging Intervention for Positive Airway Pressure UseLong-term tele-messaging was more effective than no messaging and short-term messaging for positive airway pressure use, and it was highly likely to be cost-effective with an acceptable willingness-to-pay threshold.
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What’s Next for Real-World Evidence in Oncology?Recent steps by FDA to promote the use of real-world evidence are to be commended, but the future demands a broader vision that makes greater use of growing sources of health care information.
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Teamwork Enhances Patient Experience: Linking TEAM and Net Promoter ScoresIn 1386 providers, better teamwork related to higher patient Net Promoter Score (NPS), and the relationship between provider experience and NPS was mediated by teamwork.
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Contributor: More Informed Management of Preeclampsia Is NecessaryAt present, it is difficult for clinicians to identify patients at greatest risk for developing preeclampsia with severe features and tailor treatment plans for them; this difficulty increases costs significantly.
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Atopic Dermatitis Treatment Strategies Using Ruxolitinib, Considering Crucial Role of Skin MicrobiomeLawrence F. Eichenfield, MD, FAAD, from Rady Children's Hospital and UC San Diego School of Medicine, highlighted the effectiveness of ruxolitinib cream as a nonsteroidal topical treatment for atopic dermatitis, its potential to reduce the need for systemic therapies, and the significant role of the skin microbiome in disease management.
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Comparing Spending Across Medicare ProgramsAs Medicare Advantage increasingly becomes the dominant form of Medicare coverage, Congress must improve transparency of programmatic costs and benefits to promote beneficiary choice.
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Addressing STIs Through Managed Care: Opportunities in Medicaid and BeyondMedicaid and other managed care organizations could take several key steps to respond to the sexually transmitted infection (STI) epidemic in the US, including congenital syphilis.
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Inappropriate Wrist MRI: Did Guidelines Have an Impact?This article analyzes the use of MRI in a national sample of patients with wrist pain before and after consensus guideline publication.
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Tailoring HS Treatment: The Path to Better Patient OutcomesA panelist discusses how clinicians should systematically adopt evidence-based hidradenitis suppurativa (HS) guidelines while maintaining flexibility to tailor treatments to individual patient needs, severity levels, and comorbidities. This involves regular monitoring of updated recommendations, implementing standardized assessment tools, and considering patient-specific factors such as lifestyle, preferences, and treatment response history to optimize therapeutic outcomes through a personalized medicine approach.
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Searching for the Policy-Relevant Treatment Effect in Medicare’s ACO EvaluationsThe authors discuss multiple challenges to the production of policy-relevant results from evaluation of Medicare accountable care organizations (ACOs).
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COVID-19 Control in the United States: The Case for MaskingIn the control of COVID-19, the future perfect of the vaccine should not be the enemy of the present good, which is masking.
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Behavior-Based Diabetes Management: Impact on Care, Hospitalizations, and CostsThe Diabetes Care Rewards program offers a business case for health plans to promote engagement through use of contingent incentives, thus improving health outcomes and lowering costs.
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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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Contributor: The Future of Prior Authorization Under the Improving Seniors’ Timely Access to Care ActStreamlining the prior authorization process can improve care accuracy and patient access to care, writes Siva Namasivayam, CEO of Cohere Health.
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Preventive Care: Vaccines MatterA database of information about more than 30,000 patients verified improved morbidity and mortality due to vaccines and preventive health care in prospective trials.
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Cost-effectiveness of a 3-Year Tele-Messaging Intervention for Positive Airway Pressure UseLong-term tele-messaging was more effective than no messaging and short-term messaging for positive airway pressure use, and it was highly likely to be cost-effective with an acceptable willingness-to-pay threshold.
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Understanding Insurance Coverage Policies for Incretin Mimetics for Weight ManagementThe high cost of incretin mimetics for weight management limits insurance coverage and potentiates variation in utilization management strategies to control near-term spending.
