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High-Intensity Home-Based Rehabilitation in a Medicare Accountable Care OrganizationHigh-intensity home-based rehabilitation (HIHR) may substitute for facility-based postacute rehabilitation. Patients in HIHR had better functional outcomes at lower costs than patients in facility-based care.
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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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Cost-Effectiveness of a Multicancer Early Detection Test in the USMulticancer early detection testing results in extended life-years and reduced cancer treatment costs through earlier diagnosis, leading to a cost-effective option in cancer screening.
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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.
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Actions to Improve Quality: Results From a National Hospital SurveyHospitals reported widespread adoption of quality improvement (QI) changes to improve on CMS quality measures, and QI adoption was associated with improved performance on quality measures.
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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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COPD Treatment Ratio: A Measure for Improving COPD Population HealthThis article supports the use of the chronic obstructive pulmonary disease (COPD) treatment ratio as a surrogate marker of COPD exacerbation risk for quality measurement purposes.
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Risk Assessments of Drug-Related Problems for Cardiac Surgery PatientsRisk assessments of drug-related problems for cardiac surgery patients can be conducted by implementing a framework for patient safety.
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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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The Role of Advanced Technologies in Improving Diabetes OutcomesThis article reviews underlying barriers to health care access and discusses how a value-based diabetes care model could improve patient outcomes and reduce long-term costs.
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Contributor: Optimizing Specialty Contracting to Control Costs and Improve Patient OutcomesTo control the costs of managing a complex patient population, the market is turning to value-based contracting to drive positive outcomes.
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Cannabis Improves Quality of Life in Women With Treatment-Resistant FibromyalgiaFibromyalgia is a common pain syndrome that affects women twice as much as men.
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Characteristics of Self-Triaged Emergency Department Visits by Adults With CancerAdults 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.
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The Relationship Between the Follow-up to Discharge Ratio and Length of StayThe objective was to evaluate the correlation between the follow-up to discharge ratio and average length of stay.
