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Defragmentation of Care in Complex Patients With ESKD Improves Clinical OutcomesA novel program utilizing an approach to defragment care for patients with end-stage kidney disease (ESKD) resulted in better patient outcomes.
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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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Recent Cohorts Aging Into Medicare Use More Counseling and Psychotherapy Than Past CohortsAdults currently aging into Medicare utilized counseling and psychotherapy services at higher rates than those in prior cohorts at the same age.
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AHA Telemetry Guidelines Improve Telemetry Utilization in the Inpatient SettingUsing Plan-Do-Study-Act cycles, the studied intervention reduced hospital inpatient telemetry time by 51.25% while increasing American Heart Association (AHA) guideline–based usage.
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Emergency Department Risk Model: Timely Identification of Patients for Outpatient Care CoordinationThe authors created a machine learning–based model to identify patients with major depressive disorder in the primary care setting at high risk of frequent emergency department visits, enabling prioritization for a care coordination program.
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Employer-Sponsored Behavioral Health Program Impacts on Care Utilization and CostProvision of enhanced access to behavioral health services by a large employer to its employees is associated with reductions in all-cause care utilization and cost.
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Preferences for and Experiences With Pill Appearance Changes: National Surveys of Patients and PharmacistsChanges in generic drug appearance occur often. Patients’ and pharmacists’ responses to those changes vary, with some patients stopping their medication or using it less.
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Patient-Centered Communication and Outcomes in Heart FailureAmong community patients living with heart failure, excellent and good patient-centered communication was associated with a reduced risk of death.
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Clinical Considerations in the Treatment of Alopecia AreataNeil Minkoff; Natasha Mesinkovska, MD; and Brett King, MD, PhD discuss the diagnosis and disease assessment in alopecia areata along with clinical considerations.
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An Analysis of Medicare Accountable Care Organization Expense ReportsThe authors of this study examined expense reports to understand how participants in Medicare’s Accountable Care Organization Investment Model spent to achieve program goals.
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Charitable Medication Distribution Improves Care for Uninsured Patients With DiabetesThis report illustrates how providing vital diabetes medications to uninsured patients through a charitable medication distributor improves clinical outcomes.
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Managing Total Knee Replacement Under Value-Based PaymentsThis article describes the approach that a large primary care group at risk for value-based payments chose to deploy in managing clinical and financial outcomes of knee osteoarthritis jointly with orthopedic surgeons.
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Implementation and Cost Validation of a Real-time Benefit ToolThis study evaluates impact of a real-time benefit tool on medication access and physician and pharmacy workflows at a large academic medical center.
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Factors Associated With Persistent High Health Care Utilization in Managed MedicaidSchizophrenia, chronic pain, and multiple medical diagnoses at enrollment into a large managed Medicaid system are associated with long-term high health care utilization.
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Medical Policy Determinations for Pharmacogenetic Tests Among US Health PlansThis analysis demonstrated significant variability in medical policy determinations and evidence cited for clinically relevant pharmacogenetic tests among major US health insurers and laboratory benefit managers.
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Actions to Improve Quality: Results From a National Hospital SurveyHospitals reported widespread adoption of quality improvement (QI) changes to improve on CMS quality measures, and QI adoption was associated with improved performance on quality measures.
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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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How AI, Data Analytics, and Outcomes-Based Contracts Are Shaping Health Care: Laura Bobolts, PharmD, BCOPLaura Bobolts, PharmD, BCOP, senior vice president of clinical strategy and growth at OncoHealth, shares how health care leaders are advancing value-based care through improved data strategies, real-world evidence, and AI-driven efficiencies, without losing the human touch.
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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.
