Authors
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At-Home Hemoglobin A1c Testing During COVID-19 Improved Glycemic ControlProviding at-home hemoglobin A1c test kits increases testing rates and facilitates hemoglobin A1c reduction over time among members of a large commercial health plan with diabetes.
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Impact of Hypertension on Healthcare Costs Among ChildrenThis study demonstrates a major influence of prehypertension and hypertension on healthcare costs in a large cohort of children, independent of body mass index.
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Predicting Nursing Home Placement Among Home- and Community-Based Services Program ParticipantsThe authors developed a model to identify participants in a home- and community-based services program who are at highest risk for long-term nursing home placement.
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Physician Perception of Reimbursement for Outpatient Procedures Among Managed Care Patients With Diabetes MellitusPerception of reimbursement was associated with electrocardiography but not with other common outpatient procedures. Future research should investigate how associations change with perceived reimbursement amount.
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Impact of a Scalable Care Transitions Program for Readmission AvoidanceThe 30-day readmission risk was reduced 25% by a collaborative program model employing discharge planning and telephonic follow-up for high-risk patients with CMS penalty diagnoses.
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VA Pharmacy Users: How They Differ From Other VeteransA higher proportion of veterans who use VA pharmacy services are black, have no alternative insurance, have lower incomes, are disabled, and report poorer health.
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Multilevel Predictors of Colorectal Cancer Screening Use in CaliforniaWe studied contextual factors and found that locality, availability of primary care, and HMO membership influenced use of colorectal cancer screening in California.
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Predialysis Nephrology Care Among Older Veterans Using Department of Veterans Affairs or Medicare-Covered ServicesMany older veterans do not receive appropriate nephrology care before beginning dialysis. Dual use of Veterans Affairs and Medicare-covered services was associated with better patterns of care.
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Measuring Patient-Centered Medical Home Access and Continuity in Clinics With Part-Time CliniciansCommonly used measures of performance for assessing patient access do not reflect PCMH-encouraged strategies to improve access that may be preferentially used by part-time physicians.
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Low-Value Care for Acute Sinusitis Encounters: Who's Choosing Wisely?Acute sinusitis is a common acute illness and offers an opportunity to eliminate low-value care. The authors describe current practices, comparing primary care, urgent care, and the emergency department.
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Synchronized Prescription Refills and Medication Adherence: A Retrospective Claims AnalysisA retrospective claims analysis showed that synchronized refill schedules were associated with better medication adherence among Medicare Advantage patients taking multiple maintenance medications.
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Developing Evidence That Is Fit for Purpose: A Framework for Payer and Research DialogueA decision-making framework that can be used to harmonize the evidence payer's desire for coverage and formulary decisions with the evidence generated by researchers.
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Care Coordination in Accountable Care Organizations: Moving Beyond Structure and IncentivesIn order to live up to their potential, ACOs should ensure that clinical staff possess the professional skills necessary to effectively coordinate care.
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Modeling Financial Outcomes and Quantifying Risk in Episode-Based Payment ModelsThis article provides a description of prospective financial simulation methodology and use cases with empirical data for episode-based bundled payments, including implications for contract negotiations and value-based care redesign.
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Health System Correlates of Receipt of Radiation Therapy After Breast-Conserving Surgery: A Study of Low-Income Medicaid-Enrolled WomenOmission of radiation therapy after breast-conserving surgery leads to poor outcomes. Geographic isolation and scarcity of healthcare specialists correlate with low adjuvant radiation therapy use.
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Postacute Care Partnerships and Patient ProgressionPostacute care partners are required for successful patient transitions. Collaboration among multidisciplinary teams and community resources is critical for discharge planning and partnership alignment.
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A Better Way: Leveraging a Proven and Utilized System for Improving Current Medication Reconciliation ProcessesIn this reply to the commentary, “A Call for a Statewide Medication Reconciliation Program,” published in the October 2016 issue of The American Journal of Managed Care®, authors discuss a proven and scalable solution to improve medication reconciliation that is already available to, and used by, clinicians.
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Economic/Societal Burden of Metastatic Breast Cancer: A US PerspectiveCostly new breast cancer therapies augment the significant burden this disease places on healthcare resources, but in context they may still provide value to society.
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Anticoagulation in Atrial Fibrillation: Impact of Mental IllnessAtrial fibrillation patients with mental health conditions are less likely to be eligible for warfarin receipt, and those who are eligible receive warfarin at lower rates.
