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Artificial Intelligence in Medicare: Utilization, Spending, and Access to AI-Enabled Clinical SoftwareThis study quantified the trends over time in utilization of, spending on, and access to CT fractional flow reserve, the first artificial intelligence (AI)–enabled clinical software reimbursed by Medicare.
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Health Plan Switching and Satisfaction in a Medicaid MLTSS ProgramHealth plan dissatisfaction was higher among Medicaid managed long-term services and supports (MLTSS) beneficiaries who did not follow through with an intention to change health plans.
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Evaluating Alternative Methods of Comparing Antihypertensive Treatment IntensityMedication dose captures modification of hypertension treatment intensity more precisely than medication count, and this measure should be preferred in studies that aim to improve hypertension management.
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Cost Savings From an mHealth Tool for Improving Medication AdherenceThe Wellth smartphone app significantly increased medication adherence and lowered unnecessary health care utilization and costs over 9 months among Medicaid beneficiaries who were self-managing chronic conditions.
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Contributor: The Illusion of Quality in Value-Based CareThis is the third article in a series on value-based care and the 4 challenges health care organizations must overcome.
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Assessing Opportunities to Advance Quality Measures in Adult ObesityObesity is a serious chronic disease and risk factor for a broad range of outcomes. This study identifies opportunities for improving quality in obesity care.
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Discharge Prescribing and Subsequent Opioid Use After Traumatic Musculoskeletal InjuryThe authors use surgical resident assignment as an instrumental variable for discharge opioid prescribing and estimate the impact of discharge opioid supply on subsequent 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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Tacking Upwind: Reducing Spending Among High-risk Commercially Insured PatientsAlthough commercial accountable care organization populations are healthy on average, some individuals might benefit from programs for high-risk patients to mitigate high levels of health care utilization.
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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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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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The Price Paradox of Biosimilar-Like Long-Acting InsulinFindings suggest that Basaglar was not less expensive for patients than Lantus. Empirical evaluation of biosimilar costs prior to automatic substitution is necessary.
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Integrating Primary Care and Public Health for Advance Care PlanningThis 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.
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Implementing Team-Based Telemedicine Workflows in Safety-Net Primary CareTelemedicine in safety-net primary care faces particular challenges. Consistent, team-based workflows can support video visit implementation and health care maintenance in telemedicine visits.
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Contingency Management: Promises, Gaps, and Philosophical LimitationsThis editorial reviews the promises, gaps, and philosophical limitations of contingency management for pregnant people who use drugs.
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Contributor: Reflections on World AIDS Day 2023—A Call to Increase Research Funding on HIV and AgingResearch on HIV and aging should be the focus of future research as World AIDS Day brings the chronic illness to the forefront.
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Identifying Complex Patients Using Adjusted Clinical Groups Risk Stratification ToolIn 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.
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Opioid Safety Initiative Associated With Decreased Emergency Department Opioid PrescribingA scalable health system–wide emergency physician education and feedback initiative was associated with decreased opioid prescribing, in excess of background temporal decline.
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Persistence of Provider Directory Inaccuracies After the No Surprises ActRelying on a 2-stage secret shopper survey, the authors found that inaccuracies in provider directories often persisted for well over 1 year.
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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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Post-SNF Outcomes and Cost Comparison: Medicare Advantage vs Traditional MedicarePatients 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.
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Contributor: 3 Key Questions for the Biden Administration and the 117th Congress Coming Out of the COVID-19 CrisisThe 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.
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Medication Adherence Star Ratings Measures, Health Care Resource Utilization, and CostFor 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.
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Impact of Expanded Carrier Screening on Health Care UtilizationThis study shows little evidence of harms or increased health care utilization for people receiving negative (normal) results of expanded carrier screening through genome sequencing.
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Responsibility for Treating Tobacco Dependence in Health Clinics Serving Medicaid EnrolleesThis 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.
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Cost Savings Associated With Electronic Specialty ConsultationsThis 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.
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Changing Practice Patterns in CKDClosing 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.
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Treatment Patterns for Patients With Advanced/Metastatic Cancers by Site of CareTreatment patterns and overall survival were similar regardless of site of care between patients receiving anticancer therapy in the hospital outpatient vs physician office setting.
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An Evaluation of a Care Coaching and Provider Referral Intervention for Behavioral Health NeedsCare 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.
