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Privately Negotiated Facility Fees at Ambulatory Surgery Centers and HospitalsPrivate negotiated facility fees at hospitals are on average double the ambulatory surgery center facility fees for common outpatient procedures.
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Timely Preterm-Birth Prediction Among Pregnant Women in Medicaid Without Preterm-Birth HistoryA novel prediction model is developed that accurately predicts preterm birth in a timely manner among pregnant women in Medicaid without preterm-birth history.
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TCD Screening and Spending Among Children With Sickle Cell AnemiaA substantial proportion of families of privately insured children with sickle cell anemia pay more than $100 for essential stroke screenings, a high-value service.
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Cost-effectiveness of Case Management: A Systematic ReviewThis systematic review found that studies of case management interventions have adequate quality and, in many cases, show cost-effective or even cost-saving results.
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Better Data Is Needed to Tackle Health EquityThe US federal government is finally updating its standards for reporting data on race and ethnicity – and it’s an urgently needed chance to enable a national overview of crucial data on health inequities
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Exploring Patient Spending in an ACO-Sponsored Care Management Program: A Case StudyThe authors’ multidisciplinary care management program shows promise, as the reduction in per-patient per-month spending was $116. However, these financial benefits took time to materialize.
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Journey to Anticoagulant Access Following Payer Rejection of ApixabanFormulary restrictions can create treatment barriers for patients with atrial fibrillation, including unnecessary delays in treatment and prescription abandonment, with vulnerable populations at greater risk.
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Sex Differences in Medicare Beneficiaries’ Experiences by Low-Income StatusOnly low-income male Medicare beneficiaries had worse patient experience than their female counterparts. The authors discuss opportunities to improve experiences for all patients.
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Medicaid Redeterminations Create New Financial Challenges for HospitalsHospitals and health systems have been operating in the most challenging financial environment in history, and now they face another looming headwind—the impact of Medicaid redeterminations.
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COVID-19 and Clinic Workflow Optimization Using Lean Six SigmaThe authors report an approach of outpatient clinic workflow reorganization utilizing simple, inexpensive measures to improve patient engagement and experience in addition to providing a safe setting for patients for clinic visits in the wake of COVID-19.
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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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Availability of Prices for Shoppable Services on Hospital Internet SitesOnly 60% of hospitals display their cash prices and 5% display their minimum negotiated charges on their public websites; many hospitals are in violation of new federal legislation.
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The Essential Role of Population Health During and Beyond COVID-19The authors detail how population health management enables health systems to promote public health, strengthen health system resiliency, and support financial recovery during and beyond coronavirus disease 2019 (COVID-19).
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Risk Adjusting for Medicaid Participation in Medicare AdvantageWhen comparing risk-adjustment approaches based on Medicaid status of Medicare beneficiaries, this analysis found that predicted spending levels varied depending on states’ Medicaid eligibility criteria.
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Future of MS ManagementKey opinion leaders in MS provide closing thoughts on the future of MS treatment including digital therapeutics, new generics, and pipeline drugs on the horizon.
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Safety Profiles of Neurokinin-Targeted Therapies for VMSPanelists discuss the notable adverse events observed in the OASIS trials with elinzanetant and compare the safety profiles of elinzanetant and fezolinetant with those of traditional treatments for vasomotor symptoms (VMS).
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Continuously Updated Forecasting of SARS-CoV-2 in a Regional Health SystemThis study presents a methodology for forecasting demand of COVID-19 on health resources in an integrated health system.
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Provider Barriers in Uptake of Biosimilars: Case Study on FilgrastimPrevious studies have found modest uptake of biosimilars in both commercial and Medicare populations. This study finds that the uptake varies between the rural and urban provider settings.
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The Impacts of Supplemental Benefits on Medicare Advantage Plan CompositionAfter evaluating the association between the expanded Medicare Advantage supplemental benefits and plan composition, authors determined that adoption was not associated with large demographic shifts in enrollment.
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Contributor: Advancing Health Care Consumerism Begins With Adopting a Retail MindsetAdopting a retail mindset, where patients are the primary focus of innovations, could help advance health care consumerism in the future.
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Real-world HIV Diagnostic Testing Patterns in the United StatesThis retrospective study evaluated real-world implementation of the updated CDC HIV algorithm in a large US laboratory.
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Antibiotic Practice Patterns With Procalcitonin Levels in Patients With Acute Lower Respiratory Tract InfectionAlthough clinical trials have demonstrated the utility of procalcitonin (PCT) testing and potential benefit on antibiotic stewardship, findings suggest that clinicians do not order PCT testing with regularity and also prioritize clinical judgment over PCT results.
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Measuring Continuity of Care for Diabetes: Which Visits to Include?This study examined how inclusion of different provider specialties affected Continuity of Care Index values, year-to-year stability, and association with emergency department visits.
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COVID-19 Vaccine Hesitancy and Health Literacy in US Southern StatesCOVID-19 vaccine hesitancy is not associated with health literacy. Personal perception of threat was associated with reduced vaccine hesitancy.
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Predicting Opioid Use Disorder and Associated Risk Factors in a Medicaid Managed Care PopulationA Medicaid managed care organization developed a machine learning model to identify opioid use disorder (OUD) risk factors and predict OUD incidence in its multistate population.
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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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Impact of Advance Care Planning Consults on Advance Directives CompletionImplementing advance care planning consults can increase advance directive completion rates. The authors demonstrate the impact of consults on completed advance directives in the medical record.
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ASCO 2024 Review and Needed Future Research in CDK4/6 inhibitors Early Breast CancerA panel of experts review ASCO 2024 and the need for future research in CDK4/6 inhibitors.
