Implementing a proactive provider outreach program resulted in significantly more prior authorization recertifications and a reduction in time to submission.
Findings suggest that Basaglar was not less expensive for patients than Lantus. Empirical evaluation of biosimilar costs prior to automatic substitution is necessary.
This article proposes a new model, Public-Primary ACP, that leverages coordination between primary care and public health workforces to improve delivery of advance care planning.
Telemedicine in safety-net primary care faces particular challenges. Consistent, team-based workflows can support video visit implementation and health care maintenance in telemedicine visits.
This editorial reviews the promises, gaps, and philosophical limitations of contingency management for pregnant people who use drugs.
Research on HIV and aging should be the focus of future research as World AIDS Day brings the chronic illness to the forefront.
In this study, the authors developed a method for use in primary care to identify a group of patients with complex care needs using Aggregated Diagnosis Groups.
A scalable health system–wide emergency physician education and feedback initiative was associated with decreased opioid prescribing, in excess of background temporal decline.
Medicaid managed care network adequacy standards exhibit significant heterogeneity across regions and specialties, potentially creating large variations in health care access and quality.
The 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).
Patients enrolled in Medicare Advantage had better outcomes and lower cost following skilled nursing facility (SNF) discharge than patients enrolled in traditional fee-for-service Medicare.
The incoming Biden administration will be challenged to address flex capacity, the supply chain, and real-time data as we transition from coronavirus disease 2019 (COVID-19) response to durable recovery.
For patients prescribed diabetes, hypertension, and hyperlipidemia medications, nonadherence to CMS Star Ratings quality measures of medication adherence was associated with increased health care resource utilization and costs.
This study shows little evidence of harms or increased health care utilization for people receiving negative (normal) results of expanded carrier screening through genome sequencing.
This article describes the implementation of Medicaid smoking cessation guidance in a large, urban federally qualified health center to examine how state-level provisions translated into clinic-level policies.
This retrospective cohort evaluation found that patients receiving electronic, compared with face-to-face, specialty consultation had significantly lower health care costs for at least 3 months.
Closing out the discussion, an expert in chronic kidney disease (CKD) highlights how care for patients with CKD may change in the future based on data presented at AMCP.
Treatment patterns and overall survival were similar regardless of site of care between patients receiving anticancer therapy in the hospital outpatient vs physician office setting.
Care coaching and behavioral health provider referral programs produce long-term savings, reductions in avoidable utilization, and increases in targeted services to treat behavioral health conditions.
Reporting on the real-world utilization of reference rituximab and its biosimilars can help show prescribing habits and reveal cost-saving opportunities.
As value realization eludes integrated practice units (IPUs), the authors examine 6 key value drivers for IPU teams to competitively drive volumes and hone their multidisciplinary competencies.
Spending on novel therapies in high-risk bladder cancer had minimal impact on Oncology Care Model payments to practices, according to this cohort study and an average performance estimation.
This study evaluates the cost-effectiveness and budget impact to US payers of point-of-care nucleic acid amplification tests (NAAT) for group A streptococcus.
Recommendations to address limitations in more widespread use of reflex testing in community oncology.
Data collection is not the principal roadblock behind issues with health care's massive data problem and how it hinders the referral process. In this contributor piece, Curtis Gattis, CEO and cofounder of LeadingReach, explores the issues inherent in the US medical system's current referral process and how to better it.
The federal State Health Insurance Assistance Program (SHIP) provides counseling and education on Medicare coverage options. This article highlights potential inequities in in-person SHIP service access.
In cardiovascular clinics during COVID-19, notable barriers to successful telehealth use included obtaining diagnostic information needed to deliver high-quality care and technology-related challenges for patients.
Adults with cancer may have difficulty self-assessing the clinical severity of their acute care needs, yet they rarely use a telephone triage line available to them.
Care coaching and behavioral health provider referral programs produce long-term savings, reductions in avoidable utilization, and increases in targeted services to treat behavioral health conditions.