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Contributor: Congress Must Do More to Cover Nonopioid AlternativesPreventing addiction is key to ending the opioid epidemic—2020 alone saw more than 93,000 overdose deaths—as are expanding access to treatment, promoting recovery, and building a multifaceted strategy that incorporates nonopioid alternative and their coverage by providers. Although appropriate in certain situations, opioids are not a one-size-fits-all approach.
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Experience Incentivizing Reduction of Racial and Ethnic Disparities in a Medicaid Hospital Quality Incentive ProgramConstruction of a composite measure, use of a summary disparity statistic, and measure selection are key considerations in the design of equity-focused payment programs.
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Preventive Care: Vaccines MatterA database of information about more than 30,000 patients verified improved morbidity and mortality due to vaccines and preventive health care in prospective trials.
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Investigators Advocate for Ongoing Comparison of Cancer Outcomes Among MA, FFS BeneficiariesGalen Shearn-Nance, BS, and Johnie Rose, MD, PhD, of Case Western Reserve University, acknowledge key limitations of their study and prioritize areas for further research.
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Primary Care Video and Telephone Telemedicine During the COVID-19 Pandemic: Treatment and Follow-up Health Care UtilizationTelephone visits may offer a simple and convenient option to address patient primary care needs without raising safety concerns.
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Appropriate ED Utilization Leading to Better Care CoordinationAddressing avoidable emergency department (ED) utilization takes interventions in partnership with providers.
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Care Coordination in Primary Care: Mapping the TerritoryA survey completed by 100% of leaders of diverse care systems in Minnesota participating in an observational study showed little difference in approach to care coordination.
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Clinical Outcomes in Heart Failure Monitoring: A Pooled Rates AnalysisThis systematic literature review and pooled rates analysis investigated the standard of care for patients with heart failure in the US post hospital discharge.
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Navigating Privacy and Security in Telemedicine for Primary CareThis qualitative study of patients and providers in primary care evaluated privacy and safety considerations in telemedicine following the COVID-19 pandemic.
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Understanding the Complexities of Equity Within the Emergence and Utilization of AI in Academic Medical CentersThis editorial discusses positions for academic medical centers to consider when designing and implementing artificial intelligence (AI) tools.
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Appropriate ED Utilization Leading to Better Care CoordinationAddressing avoidable emergency department (ED) utilization takes interventions in partnership with providers.
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Operating Room Efficiency of Orthopedic Surgery During the COVID-19 EraThe authors analyzed the impacts of COVID-19 on orthopedic operating room efficiency via comparison of 14,856 surgeries performed before, during, and after the pandemic.
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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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Medicare Payment Rule Threatens Access to Life-Sustaining Kidney CareThe authors call on Congress to reform Medicare reimbursement for dialysis, saying the recent rule puts clinics at risk of closure.
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Impact of Psychiatric Follow-Up Frequency on Outcomes and Waiting TimesNaturally occurring variations in appointment frequencies do not appear to have a major impact on clinical outcomes, but they significantly affect waiting times.
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Perspectives on Nonmedical Switching and the COVID-19 Pandemic: A Narrative ReviewThis review describes the impact of nonmedical switching of biologic therapies on US patients and providers, with a focus on switching to in-class alternatives.
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Reducing Readmissions in the Safety Net Through AI and AutomationArtificial intelligence (AI) and electronic health record–based automation tools helped a safety-net health system meet performance-based readmission metrics, thereby retaining critical funding while improving clinical and equity outcomes.
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A Scoping Review of US Insurers’ Use of Patient-Reported OutcomesThis scoping review found 350 articles that discuss US health insurance providers’ use of patient-reported outcomes about health-related quality of life.
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Association of Opioid Utilization Management With Prescribing and OverdoseOpioid utilization management in Medicare was associated with mixed effects on opioid prescribing, and prior authorization was associated with a decreased likelihood of subsequent overdose.
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Atsena Therapeutics and Nippon Shinyaku Enter Exclusive License Agreement for ATSN-101Atsena Therapeutics and Nippon Shinyaku have formed an exclusive licensing agreement for ATSN-101, a gene therapy for Leber congenital amaurosis (LCA1). Nippon Shinyaku will commercialize ATSN-101 in the US and Japan, while Atsena retains global rights outside these territories.
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Rusfertide Cuts Phlebotomy Need in Polycythemia Vera: Andrew Kuykendall, MDIn this fourth part of a discussion with The American Journal of Managed Care®, Andrew Kuykendall, MD, clinical researcher at Moffitt Cancer Center and VERIFY investigator, speaks to the impressive patient-reported outcomes seen thus far.
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Impact of Delayed Adoption of Novel Atrial Fibrillation TreatmentsUsing direct oral anticoagulants as a case study, the authors examined how delayed adoption of novel treatments could impact patient health outcomes and cost.
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Non–Face-to-Face Care Management and Service Utilization in Patients With DiabetesCMS began reimbursement for non–face-to-face chronic care management in 2015, and results from Louisiana show that it increases outpatient visits but decreases inpatient and emergency department encounters.
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Contributor: Leveraging Telehealth to Improve Access to Care for Maternal HealthThis article explores the challenges and highlights actionable telehealth solutions that enhance access to care, particularly for mothers at higher risk of postpartum depression.
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Primary Care Visit Cadence and Hospital Admissions in High-Risk PatientsPatients with congestive heart failure and/or chronic obstructive pulmonary disease who had more quarterly primary care visits had lower rates of hospitalizations during the COVID-19 pandemic.
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Development and Validation of the COVID-19 Hospitalized Patient Deterioration IndexThe authors developed and validated an accurate, well-calibrated, easy-to-implement COVID-19 hospitalized patient deterioration index to identify patients at high or low risk of clinical deterioration.
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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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After Tornado Damages Pfizer Plant, Hospitals Brace for ShortagesAnalysts warned of the potential for some shortages until the company can move production elsewhere. The North Carolina plant produces a quarter of the company’s sterile injectables used in hospitals.
