Authors
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Factors Associated With Persistent High Health Care Utilization in Managed MedicaidSchizophrenia, chronic pain, and multiple medical diagnoses at enrollment into a large managed Medicaid system are associated with long-term high health care utilization.
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Access to Consultative Dermatologic Care via Physician-to-Physician Asynchronous Outpatient TeledermatologyDirect access of primary care physicians to dermatologists via asynchronous teledermatology improves a health system’s ability to increase patient access to dermatologic care.
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Noninvasive Ventilation at Home Reduces Mortality in COPD With CRFThis study explores the association between receiving noninvasive ventilation at home and mortality, hospitalizations, and emergency department visits in patients with chronic obstructive pulmonary disease (COPD) with chronic respiratory failure (CRF).
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Chronic Overlapping Pain Conditions and Long-term Opioid TreatmentLittle is known about opioid prescribing patterns in patients with chronic overlapping pain conditions. This study suggests target populations for interventions to manage chronic pain.
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Impact of COVID-19 Pandemic on Accessibility of Taiwanese Medical CareThe COVID-19 pandemic disrupted access to routine medical care in community populations in Taiwan. The unmet needs should be emphasized as normal life resumes.
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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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Care Management Improves Total Cost of Care for Patients With DementiaCompared with usual care, a dementia care management program improved various cost of care and utilization metrics in a Medicare managed care population at 12 months.
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Impact of the Patient-Centered Medical Home on Consistently High-Cost PatientsPatient-centered medical homes in Maryland’s multipayer demonstration disrupted the pattern of recurrently high expenditure among the costliest patients and improved continuity of care.
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Maternal Navigation: For the Common GoodMaternal navigation for pregnant patients who chronically miss prenatal care appointments is necessary to reduce premature births and associated health care costs.
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Psoriatic Arthritis Treatment Patterns and Costs Among Pharmacologic Treatment–Naïve PatientsWe present results of an analysis of IBM MarketScan databases that evaluates treatment patterns and health care costs for treatment-naïve patients with psoriatic arthritis.
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PQA Annual Meeting: Quality Emerges From the Pandemic, Focused on Access and EquityThe Pharmacy Quality Alliance's 2022 annual meeting will return to an in-person format after 2 years. The meeting with include timely topics: quality beyond the pandemic, health equity, and remote care
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Out-of-Pocket Costs for Diabetes Medications in Employer-Sponsored Health Insurance PlansOut-of-pocket costs of diabetes medications other than insulin can be quite high for individuals with employer-sponsored health insurance.
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Understanding Insurance Coverage Policies for Incretin Mimetics for Weight ManagementThe high cost of incretin mimetics for weight management limits insurance coverage and potentiates variation in utilization management strategies to control near-term spending.
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Remote Monitoring Saves Costs in Outpatient Negative Pressure Wound TherapyHealth insurance records of patients using negative pressure wound therapy (NPWT) revealed lower adjusted 90-day wound-related costs with remote therapy monitoring vs NPWT alone.
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Diagnosis Patterns and Stress Testing Trends After Implementing High-Sensitivity Troponin AssayThis study found that switching from a conventional troponin assay to a high-sensitivity troponin assay resulted in changes to diagnosis patterns and stress testing trends.
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Journey to Anticoagulant Access Following Payer Rejection of ApixabanFormulary restrictions can create treatment barriers for patients with atrial fibrillation, including unnecessary delays in treatment and prescription abandonment, with vulnerable populations at greater risk.
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Future Directions in the Management of Multiple MyelomaAlfred L. Garfall, MD, discusses his hopes for the future treatment landscape of multiple myeloma.
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Utilization Management and Physician BurnoutThis survey assesses physician experiences with utilization management and burnout and investigates whether there is a link between them.
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Challenges of Fracture Risk Assessment in Asian and Black WomenDifferences in bone density and FRAX fracture risk scores among Black and Asian women yield greater discordance in fracture risk estimation compared with White women.
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Impact of the Collaborative Care Model on Medical SpendingModest spending on integrated mental health services in primary care, facilitated by use of new collaborative care billing codes, did not increase overall health care costs.
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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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Approaches for Overcoming Barriers to Cross-Sector Data SharingThe authors identified challenges to cross-sector data sharing and the approaches used to overcome these challenges in the Mid-Ohio Farmacy, a partnership to address food insecurity.
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Hospital Outcomes of Male Breast Cancer in the United StatesThis is the first study to estimate the hospital lengths of stay and costs of male breast cancer at the US population level.
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Tackling Colorectal Cancer Care Inequities Through Patient Advocacy GroupsKim Newcomer, director of volunteers, Colorectal Cancer Alliance, shares findings from a survey on colorectal cancer care inequities, and how to address these challenges.
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Medicare Advantage Coverage Restrictions for the Costliest Physician-Administered DrugsFour large Medicare Advantage insurers manage access to expensive physician-administered drugs with a combination of prior authorization, step therapy, and Part D formulary design.
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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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What Value Do Teaching Hospitals Provide Commercial Beneficiaries When in an ACO?Accountable care organizations (ACOs) with a major teaching hospital were associated with lower mortality, lower inpatient spending, lower emergency department utilization, and higher overall outpatient spending.
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Association Between Interhospital Care Fragmentation, Readmission Diagnosis, and OutcomesIn this analysis of the National Readmissions Database, the authors investigated the association between interhospital fragmentation of care, reason for readmission, and patient outcomes.
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Inappropriate Wrist MRI: Did Guidelines Have an Impact?This article analyzes the use of MRI in a national sample of patients with wrist pain before and after consensus guideline publication.
