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Factors Associated With Lung Cancer Risk Factor DocumentationThis cross-sectional observational study found several factors associated with whether a patient had sufficient lung cancer risk factor documentation in the electronic health record.
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Cardiovascular Disease Risk Management During COVID-19: In-Person vs Virtual VisitsThis article compares cardiovascular disease risk management in community clinics during the COVID-19 pandemic among patients for whom primary care was delivered mostly in person vs mostly virtually.
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Patterns of Opioid Use in Commercially Insured Patients With CancerAmong the fewer than half of patients with cancer who received opioid fills, a relatively small proportion (2.5%) had potentially problematic opioid use.
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Projected US Savings From Biosimilars, 2021-2025Projected savings from biosimilars from 2021 to 2025 were $38.4 billion vs conditions as of quarter 4 of 2020 and were driven by new biosimilar entry. Savings were $124.5 billion under an upper-bound scenario.
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Transitional Care Management Visits to Improve Coordination of CareInspira Care Connect, LLC, an accountable care organization, incorporated transitional care management services into its postdischarge follow-up process to prevent avoidable utilization of health care services and costs.
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Diabetes, Gaps in Care Coordination, and Preventable Adverse EventsThe authors examined the association of diabetes with self-reported gaps in care coordination and self-reported preventable adverse events using data from a national sample of older adults.
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Medicare Accountable Care Organizations Reduce Spending on SurgeryMedicare Shared Savings Program accountable care organizations spent less on surgical care by reducing inpatient surgery, increasing outpatient surgery, and reducing spending on postacute care after inpatient surgery.
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Contributor: Transforming Prior Authorization to Facilitate Quality CarePayers must continue to assess their prior authorization practices to uphold the goals of clinical quality, safety, and utilization management.
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Building Research Capacity in Primary Care Practices That Serve Predominantly Racial and Ethnic Minority PopulationsThe successful collaboration between a primary care–based network of practices and academic researchers demonstrates feasibility and the need for more funding for primary care research.
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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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Regional Market Factors and Patient Experience in Primary CarePatient-provider communication quality metrics at safety net hospitals are indirectly affected by changes in regional market factors that influence patients’ demand for care.
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An Outpatient Critical Care Transition Clinic Model Reduces Admissions/Readmissions in Medically Complex PatientsCritical care transition clinic patients with chronic conditions had a 31% reduction in relative risk for inpatient admissions, and the clinic reduced cost by more than $1 million.
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Policy Solutions to Facilitate the New eCQM ACO Reporting and Advancement of InteroperabilityThis article describes the challenges associated with aggregating and reporting quality data via electronic health records and discusses corresponding policy solutions.
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Rheumatoid Arthritis Medication Adherence in a Health System Specialty PharmacyIntegrated health system specialty pharmacies provide specialized services to patients, resulting in high rates of adherence to and financial assistance with specialty disease-modifying antirheumatic drugs.
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Social Determinants of Health Score: Does It Help Identify Those at Higher Cardiovascular Risk?Calculating a social score is feasible and it predicts cardiovascular outcomes. In order to do this, institutions have to collect social determinants of health.
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Utilization Management and Physician BurnoutThis survey assesses physician experiences with utilization management and burnout and investigates whether there is a link between them.
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Rituximab Reference vs Biosimilar Utilization for Oncology vs Nononcology IndicationsReporting on the real-world utilization of reference rituximab and its biosimilars can help show prescribing habits and reveal cost-saving opportunities.
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Cost-effectiveness of Nivolumab in Patients With NSCLC in the United StatesThis article presents a cost-effectiveness analysis of nivolumab vs docetaxel from the US payer perspective in non–small cell lung cancer (NSCLC) based on randomized phase 3 studies with a minimum 5 years of follow-up.
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Transitions of Care: Supporting Patients and Physician PartnersAn emphasis on transitions of care should ensure the highest level of care for patients and provide support to physicians.
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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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Rethinking Deprescribing: Who Should Monitor “Drug Overload”?Health plan pharmacists are in the perfect position to see overprescribing as it happens.
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Activation, Physical Activity, and Outcomes Among Individuals With T2DThis study presents an integrated, exploratory assessment of physical activity, patient activation, health-related quality of life, and clinical outcomes among older adults with type 2 diabetes (T2D) using survey, wellness, and claims data.
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HPV 16 and 18 Linked to Ovarian Cancer RiskIn a recent meta-analysis, the prevalence of human papillomavirus (HPV), especially types 16 and 18, was significantly increased among patients with ovarian cancer (OC) vs controls.
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Managed Critical Care: Impact of Remote Decision-Making on Patient OutcomesThis work serves as a step toward better understanding the implications of remote critical care intervention by evaluating levels of tele–intensive care unit decision-making authority.
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Oncology Alternative Payment Models: Lessons From Commercial InsuranceDeveloping alternative payment models for commercial populations in specialties such as oncology is rife with practical challenges. Leading payers and practices share lessons to date.
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Factors Associated With Lung Cancer Risk Factor DocumentationThis cross-sectional observational study found several factors associated with whether a patient had sufficient lung cancer risk factor documentation in the electronic health record.
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Real-World Users of Triple Therapy for Asthma in the USThis retrospective cohort study evaluated baseline demographics, clinical characteristics, and treatment patterns of US patients with asthma who newly initiated single- or multiple-inhaler triple therapy.
