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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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Payment Incentives and the Use of Higher-Cost Drugs: A Retrospective Cohort Analysis of Intravenous Iron in the Medicare PopulationDuring a period of rapid fluctuation in the intravenous iron market, there was increased use of a more expensive drug that afforded providers additional revenue.
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Evaluating Proactive Outreach for Prior Authorization Recertifications in Medicaid PatientsImplementing a proactive provider outreach program resulted in significantly more prior authorization recertifications and a reduction in time to submission.
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Characterizing Patient Flow After an Academic Hospital Merger and AcquisitionThis study assessed health care utilization and patient flow after a recent merger of community practices, a community hospital, and an academic medical center.
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Medication Persistence and Its Impact on Type 2 DiabetesMost newly treated patients with type 2 diabetes exhibit suboptimal medication persistence, which is associated with higher risk of hospitalization and increased medical costs.
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Medicare Advantage Enrollment by Immigration and English Proficiency StatusMedicare Advantage enrollment was higher among immigrants compared with US-born residents, but the highest enrollment was found among immigrants with limited English proficiency.
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A Case-Control Study of Length of Stay OutliersLength of stay outliers are associated with hospital-acquired infections, complications, and discharge to facility, as opposed to nonmodifiable risk factors like age and comorbidities.
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Primary Care Redesign and Care Fragmentation Among Medicare BeneficiariesThis article examines the association between a large-scale primary care redesign—the Comprehensive Primary Care Plus Initiative—and ambulatory care patterns of Medicare beneficiaries with highly fragmented care.
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Using Telemedicine Interventions During COVID-19 to Expand Care Post COVID-19The Patient-Centered Rheumatology Collaborative identified several critical areas for further intervention to improve the delivery of high-quality, patient-centered care during the COVID-19 pandemic and beyond.
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Outcomes of Antiviral Treatment for Influenza in Type 2 DiabetesAntiviral treatment was associated with lower health care resource utilization and costs in patients with type 2 diabetes and a diagnosis of influenza.
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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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Intersection of Complexity and High Utilization Among Health Center Patients Aged 18 to 64 YearsThis paper utilizes latent class analysis to identify subgroups of complex conditions and of super-utilizers among health center patients to inform clinically tailored efforts.
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Care Fragmentation Predicts 90-Day Durable Ventricular Assist Device OutcomesThis analysis evaluates the relationship between hospital care delivery network fragmentation and in-hospital and 90-day outcomes. These networks may be novel targets for improving outcomes.
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Mental Health Diagnoses and Services Utilization Vary by Wage LevelInsured lower-wage employees had lower prevalence of mental health conditions but greater severity, with more hospital admissions and emergency department visits than high-wage employees.
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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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Leveraging Longitudinal Clinical Laboratory Results to Improve Prenatal CareCollaboration between a clinical laboratory and a managed care organization improved prenatal care and outcomes through real-time, actionable, laboratory-derived insights and care coordination.
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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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Patient and Supporter Factors Affecting Engagement With Diabetes TelehealthFamily support with medication management and recent urgent self-management concerns are 2 novel factors, among others, that predict completion of diabetes telehealth calls.
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Cost Analysis of Self-Monitoring Blood Glucose in Nonintensively Managed Type 2 DiabetesAnalysis of claims data showed reduced utilization and costs among patients with nonintensively managed type 2 diabetes using self-monitoring of blood glucose compared with continuous glucose monitoring.
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Teamwork Measure Relates to Provider Experience, Burnout, and Intent to StayA 6-item teamwork measure with good construct validity correlated with favorable provider outcomes including work experience, burnout, and intent to stay with the organization.
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Treatment Modification After Initiating Second-Line Medication for Type 2 DiabetesAmong adults with type 2 diabetes who started noninsulin second-line therapy, most modified treatment within 1 year. Discontinuation was by far the most common modification.
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Limiting Medicaid Access to Accelerated Approval Drugs: Costs and ConsequencesAccelerated approval drugs account for less than 1% of Medicaid spending, but states seek CMS approval to avoid coverage of these drugs and cut costs.
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The Implementation of Opioid Prescribing Report Cards in Medicaid Managed Care: A Community Quality CollaborativeThis article describes the Philadelphia Medicaid Opioid Prescribing Initiative that was launched by a multidisciplinary team and mailed local Medicaid providers individualized prescribing report cards.
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Contributor: Fusing Real-world Evidence With Peer-Reviewed ResearchResearch as we know it today, done in isolation and seemingly protected from real-world evidence (RWE), may one day soon be the exception vs the norm, as our ability to amass and extract insights from RWE grows. It’s time that researchers and other industry stakeholders acknowledge the power of using different data sources in a complementary manner to tackle some of health care’s most difficult problems.
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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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Health Insurance, Blood Cancer Care, and Outcomes: A Literature Reviewdoi: 10.37765/ajmc.2021.88733
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Psychological Safety and Use of Incident Reporting SystemsIncident reporting systems, which are often computer based and require no in-person interactions, can enable health care staff who perceive low psychological safety to speak up.
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Spending Patterns Among Commercially Insured Individuals During the COVID-19 PandemicIn this analysis of more than 97 million commercially insured individuals, investigators found that the COVID-19 pandemic induced a spending shock in 2020 and that health care spending did not recover to baseline until mid-2021.
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Value-Based Care Through Postacute Home Health Under CMS PACT RegulationsAmong a patient population defined by CMS postacute care transfer regulations, home health vs no postacute care was associated with reduced 30-day readmissions and costs.
