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Physician-Led Tech Firms Use AI to Counter Drug Denials and Augment AppealsAs drug denials increase, experts discuss the importance of optimizing data to keep up with these changes and implementing artificial intelligence (AI) to reduce the burden on providers and ensure patient access to care and treatment.
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Covishield India: Demystifying Myths Through an Early Multicenter Safety StudyThis was a multicenter study carried out in India to study the adverse and systemic effects of the indigenously developed Covishield vaccine.
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Process Reengineering and Patient-Centered Approach Strengthen Efficiency in Specialized CareImproving efficiency is complex and requires a multimodal approach. Health information systems, patient feedback, and multidisciplinary teams are components that can improve clinical processes.
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Successes and Failures With Bundled Payments in the Commercial MarketThe relatively few examples of commercially funded condition-specific bundled payments provide insights into how to spread this alternative payment model further in the private insurance market.
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Outcomes of Antiviral Treatment for Influenza in Type 2 DiabetesAntiviral treatment was associated with lower health care resource utilization and costs in patients with type 2 diabetes and a diagnosis of influenza.
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Association of Dermatology Wait Times With Insurance Coverage in MichiganDisparities in dermatologic care for patients with Medicaid exist, and delays in medical dermatologic care among Medicaid patients must be addressed.
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Health Equity in the Era of Large Language ModelsThis article presents challenges and solutions regarding health care–focused large language models (LLMs) and summarizes key recommendations from major regulatory and governance bodies for LLM development, implementation, and maintenance.
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Trump Tariffs on Pharmaceuticals Risk Causing Higher Costs, Drug ShortagesThe Trump administration is proceeding with probes into the national security implications of pharmaceutical imports.
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Advancing HIV Care With Doravirine and Islatravir: Q&A With Amy Colson, MD, MPHNew data from the MK-8591A-051 and MK-8591A-052 trials, both investigating the efficacy and safety of 100-mg doravirine and 0.25-mg islatravir as a once-daily 2-drug regimen for virologically suppressed people living with HIV-1, were presented today by Amy Colson, MD, MPH.
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Unlocking Access: Exploring Mental Health Care Among Medicaid Managed Care EnrolleesOn this episode of Managed Care Cast, we speak with the author of a study published in the January 2025 issue of The American Journal of Managed Care® to examine the association between quantitative network adequacy standards and mental health care access among adult Medicaid enrollees.
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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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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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Medicaid Managed Care: Further Reform Needed to Deliver on PromiseMedicaid managed care has not been the panacea for spending, care quality, and access that policy makers expected, but reforms could change that.
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Association of Physician Coordination With Interfacility Transfer Acceptance TimelinessThe authors reviewed physician-to-physician conversations during emergency transfer of patients with ST-segment elevation myocardial infarction and found that higher-quality physician coordination was associated with faster time to acceptance.
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Effect of Care Coordination on Patients With Alzheimer Disease and Their CaregiversThe authors investigated whether patient coordination and caregiver support for Alzheimer disease reduced health care utilization and expenditures among enrollees in the Memory Program in South Carolina.
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HIV Cure the Goal of Future Study Into Genetic Tagging: Benjamin K. Chen, MD, PhDBenjamin K. Chen, MD, PhD, discussed the next steps after the results of his study in genetic tagging showed promise in targeting HIV cells.
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Behavior-Based Diabetes Management: Impact on Care, Hospitalizations, and CostsThe Diabetes Care Rewards program offers a business case for health plans to promote engagement through use of contingent incentives, thus improving health outcomes and lowering costs.
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Patient-Centered Communication and Outcomes in Heart FailureAmong community patients living with heart failure, excellent and good patient-centered communication was associated with a reduced risk of death.
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Estimating the Economic Burden of Migraine on US EmployersThe Migraine Impact Model is an interactive calculator that estimates migraine prevalence within a workforce and the associated economic burden of migraine on the employer.
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Pharmacist Hypertension Management Using an Electronic Health Record–Based ApproachThe authors studied the impact of a pharmacist intervention on blood pressure control compared with usual care.
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Adolescent Anterior Cruciate Ligament Reconstruction: A Decade of Rising Surgical CostAdolescent anterior cruciate ligament reconstruction surgery can preserve health and restore function of the knee joint, but the surgical cost has outpaced inflation.
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Contingency Management in a Perinatal Substance Exposure ClinicProject CARA, a perinatal substance exposure clinic, has implemented a contingency management program that targets appointment attendance for patients with any use disorder, regardless of substance or urine drug screen results.
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Geographic Variations and Facility Determinants of Acute Care Utilization and Spending for ACSCsEmergency department (ED) visits and hospitalizations for ambulatory care–sensitive conditions (ACSCs) among Medicaid patients constitute almost 40% of all ED visits and hospitalizations, with lower rates observed in areas with greater proximity to urgent care facilities and density of rural health clinics.
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Closing Thoughts on Iron Deficiency AnemiaPanelists discuss how the successful management of iron deficiency anemia requires a comprehensive approach combining early detection, appropriate choice of iron formulation, careful monitoring of treatment response, and addressing barriers to care while emphasizing the importance of patient education and health care system support in achieving optimal outcomes.
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Care Transitions: Opportunities to Better Serve the Traveling PatientThe authors share a model that facilitates patient-centered care and can be adopted by other health systems to encourage successful care transitions for the traveling patient.
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NSCLC Advancements Offer Hope, but Disparities PersistIoana Bonta, MD, Georgia Cancer Specialists, discusses the evolving state of non-small cell lung cancer (NSCLC) treatments, their impact on patient outcomes, and the need to address ongoing disparities in these populations.
