Authors

Medicare Accountable Care Organizations Reduce Spending on Surgery

Medicare 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.

Medicare Payment Rule Threatens Access to Life-Sustaining Kidney Care

The authors call on Congress to reform Medicare reimbursement for dialysis, saying the recent rule puts clinics at risk of closure.

Specialty and Operator Status Influence Electronic Health Record Use Variation

Operators demonstrated specialty-specific differences in electronic health record efficiency, timeliness, and after-hours use, highlighting how workflow and training shape documentation behaviors across medical disciplines.

Impact of Psychiatric Follow-Up Frequency on Outcomes and Waiting Times

Naturally occurring variations in appointment frequencies do not appear to have a major impact on clinical outcomes, but they significantly affect waiting times.

Improving Access and Care for All Patients With Atopic Dermatitis

Panelists discuss how successful access initiatives include integrated specialty pharmacies, community-based clinics, clinical trial opportunities, telehealth services, and financial assistance programs like 340B to serve underserved populations with atopic dermatitis.

Reducing Readmissions in the Safety Net Through AI and Automation

Artificial 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.

A Scoping Review of US Insurers’ Use of Patient-Reported Outcomes

This scoping review found 350 articles that discuss US health insurance providers’ use of patient-reported outcomes about health-related quality of life.

Association of Opioid Utilization Management With Prescribing and Overdose

Opioid utilization management in Medicare was associated with mixed effects on opioid prescribing, and prior authorization was associated with a decreased likelihood of subsequent overdose.

Atsena Therapeutics and Nippon Shinyaku Enter Exclusive License Agreement for ATSN-101

Atsena 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.

Impact of Delayed Adoption of Novel Atrial Fibrillation Treatments

Using direct oral anticoagulants as a case study, the authors examined how delayed adoption of novel treatments could impact patient health outcomes and cost.

Scaling Early Palliative Care in Value-Based Community Oncology: A Technology-Enabled Approach

Non–Face-to-Face Care Management and Service Utilization in Patients With Diabetes

CMS 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.

Contributor: Leveraging Telehealth to Improve Access to Care for Maternal Health

This article explores the challenges and highlights actionable telehealth solutions that enhance access to care, particularly for mothers at higher risk of postpartum depression.

Primary Care Visit Cadence and Hospital Admissions in High-Risk Patients

Patients 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.

Development and Validation of the COVID-19 Hospitalized Patient Deterioration Index

The 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.

Building Research Capacity in Primary Care Practices That Serve Predominantly Racial and Ethnic Minority Populations

The 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.

After Tornado Damages Pfizer Plant, Hospitals Brace for Shortages

Analysts 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.

The Biosimilar Shift: Trending Infliximab Biosimilar Utilization and Associated Cost Savings for Commercial Insurance

Infliximab biosimilars created price competition causing insurance claims costs for infliximab originator and infliximab biosimilars to decrease, generating significant savings to the health care system.

Improving Care Coordination and Reducing ED Utilization Through Patient Navigation

A navigation program demonstrated decreased odds of repeat emergency department (ED) visits in patients with low baseline ED utilization and increased odds of follow-up primary care appointments.

How Do Primary Hospitals Enact Early Response to the Relaxation of COVID-19 Prevention and Control Measures? The Experience From Chengdu, China

This article examines how primary hospitals in Chengdu, China, responded to the relaxation of COVID-19 prevention and control measures in December 2022.

Patterns of Opioid Use in Commercially Insured Patients With Cancer

Among the fewer than half of patients with cancer who received opioid fills, a relatively small proportion (2.5%) had potentially problematic opioid use.

Older Adults’ Perspectives on Emergency Department Costs During COVID-19

Most older US adults have concerns about emergency department visit affordability. Lower income, being uninsured, poor or fair physical/mental health, and younger age were associated with increased concerns.

Comment on COVID-19 Vaccine Hesitancy and Health Literacy

This letter discusses COVID-19 vaccine hesitancy and health literacy.

Evaluation of a Pediatric Asthma High-risk Scoring Algorithm

An asthma risk score using 7 clinically relevant parameters evaluated in a pediatric Medicaid managed care population can stratify risk for following-year asthma hospitalization.

How Value-Based Care With Provider Enablement Improves Maternal and Infant Outcomes in Medicaid

Supported value-based care improves prenatal care while reducing neonatal intensive care unit stays, preterm birth rates, low birth weight rates, and costs for mothers and infants.

Longitudinal, Relationship-Based Case Management: A Prospective Cohort Trial

A longitudinal, relationship-based case management approach significantly reduced health care costs and improved quality of life for Medicaid enrollees with complex needs over 1 year.

Workforce Innovation Reduces Medicaid Costs in Chronic Care

This study of community health workers as clinical extenders demonstrates significant cost savings in managing chronic conditions among Medicaid beneficiaries.

Economic Burden of Joint Disease in Psoriasis: US Claims Analysis

This retrospective claims analysis found that concomitant joint disease in psoriasis is associated with greater health care resource utilization and health care costs than psoriasis alone.

Impact of Travel Distance on Quality Outcomes in Colorectal Cancer

This study identified characteristics of patients with colorectal cancer who traveled farther for surgery and found that those who traveled tended to stay longer at the hospital.

Contributor: An Urgent Call to Action as Colorectal Cancer Rates Skyrocket Among Young People

As rates of CRC skyrocket in young individuals, means of addressing the growing problem must be considered.