Authors
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Predictors of Discharge From the VA Caregiver Support ProgramThe year of application predicts discharge from the Department of Veterans Affairs (VA) caregiver program. Unexpected, disallowed criteria also predict discharge, with significant others facing higher discharge risk than spouses.
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A Machine Learning Technology for Addressing Medication-Related Risk in Older, Multimorbid PatientsA novel machine learning system effectively stratifies emergency department use and hospitalization risk of older patients with multimorbidity who take multiple medications and provides appropriate medication recommendations.
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A Strategy to Promote Population-Wide Life Satisfaction While Advancing EquityThe authors used health care claims and survey data to identify a strategy that might promote life satisfaction while advancing equity in an insured population.
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Empiric Segmentation of High-risk Patients: A Structured Literature ReviewData-driven segmentation of high-risk patient populations may inform health system interventions, but results are dependent on the data sources and methods applied.
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Differences in Spending for Diabetes and Multiple Chronic Conditions in Michigan Medicare BeneficiariesDiabetes and multiple chronic conditions increase overall Medicare spending, but spending increases even more in minority beneficiaries compared with White beneficiaries with similar comorbidity combinations.
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Mental Health Service Utilization Review Patterns in a Medicaid Managed Care ProgramMedicaid managed care utilization review data for mental health services were analyzed for the calendar years 2017 and 2018. These data indicate low rates of utilization review denials for both inpatient and outpatient mental health services.
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The PANDEMIC Framework for Encouraging COVID-19 VaccinationsThis commentary offers 8 promising approaches forming a framework known as PANDEMIC to address COVID-19 vaccination hesitancy.
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Health Care Costs Associated With Unrecognized Progression to Late-Stage Kidney DiseaseUnrecognized disease progression is associated with higher health care costs both for patients with end-stage kidney disease and late-stage (stages G4-G5) chronic kidney disease.
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CMS Practice Assessment Tool Validity for Alternative Payment ModelsUsing data from 632 primary care practices, the authors show that the CMS Practice Assessment Tool has adequate predictive validity for participation in alternative payment models.
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Economic Burden of Nonadherence to Standards of Diabetes CareUsing propensity score matching in a US nationally representative sample, authors found the effect of nonadherence to diabetes guidelines on health care expenditures of patients with diabetes.
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Impact of Including Drug Spending in Oncology Alternative Payment ModelsThis study demonstrates a method for understanding the effects of drug spending in the design of alternative payment models.
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Primary Care Referrals to Nephrology in Patients With Advanced Kidney DiseasePrimary care physicians did not refer the majority of patients with severe nephropathy to specialists; nonreferred patients had fewer comorbidities and might be better kidney transplant candidates.
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Future of PrEPExperts in HIV provide closing thoughts on the future of PrEP, including improvement of uptake and addressing access disparities.
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Contributor: Navigating Health Equity in 2024: The Evolution of Accountability, Part 2The article emphasizes the significance of accreditations in addressing health disparities and promoting health equity, highlighting programs for achieving accreditation and advocating for the integration of social determinants of health (SDOH) and health equity practices within pharmacy and health care.
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ACA Medicaid Expansion Association With Racial Disparity Reductions in Timely Cancer TreatmentMedicaid expansion was associated with a reduction in the racial disparity in timely treatment of patients with advanced cancer in the United States.
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Long-term Medication Adherence and Preventive vs Reactive Care Utilization Among Older Adults With DiabetesThis study using Medical Expenditure Panel Survey data found greater health care utilization and expenditure among adults 65 years and older who were adherent to oral hypoglycemic agents.
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Impact of Primary Care Intensive Management on Medication Adherence and AdjustmentsThe Veterans Health Administration implemented primary care intensive management for high-risk patients. Impacts of this program on patients’ medication adherence and adjustments were modest.
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Applying Upstream Problem-Solving to Value-Based Payment Reform in Specialty Care: Blue Cross Blue Shield of North Carolina’s ApproachEffectively designing and implementing value-based payment reform for specialty care is challenging. The authors describe a commercial payer’s strategic approach to specialty value transformation.
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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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The Extent and Growth of Prior Authorization in Medicare AdvantagePrior authorization is a common utilization-management tool among Medicare Advantage plans. However, service-, area-, and carrier-level patterns suggest variation in how plans use prior authorization.
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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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Physician Prices and Low-Value Services: Evidence From General Internal MedicineThis study found extensive variation in general internal medicine physician prices and that high-priced physicians provided fewer low-value services but had higher spending on these services.
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The Impact of HDHPs on Service Use and Spending for Substance Use DisordersOffering a high-deductible health plan (HDHP) led to a 6.6% reduction in the probability of using substance use disorder services and a shift in spending from the plan to the enrollee.
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The Relationship Between Preventive Dental Care and Overall Medical ExpendituresUsing an instrumental variable approach, this study is the first to present causal estimates of the effect of preventive dental visits on overall medical expenditures.
