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Affordability in a Mandated EnvironmentThe state of Hawaii has mandated employer-based coverage since 1974, offering an opportunity for learning as implementation of the Affordable Care Act ramps up.
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Placement of Selected New FDA-Approved Drugs in Medicare Part D Formularies, 2009-2013There is significant heterogeneity in formulary placement and restrictions on new drug approvals in the Part D marketplace.
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Improving Population Health Through Multistakeholder PartnershipsImproving population health requires developing innovative multistakeholder partnerships to enable mining and cross-leveraging data sets, creating patient touchpoint “ecosystems,” and aligning investments with each stakeholder’s returns.
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Postdischarge Engagement Decreased Hospital Readmissions in Medicaid PopulationsPostdischarge engagement of at-risk Medicaid beneficiaries in 6 health plans resulted in significant reductions in hospital readmissions at rates proportional to the frequency of engagement.
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Electronic Health Record Problem Lists: Accurate Enough for Risk Adjustment?Electronic health record (EHR)-based comorbidity assessment had low sensitivity for identifying major comorbidities and poorly predicted survival. EHR-based comorbidity data require validation prior to application to risk adjustment.
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Evolving Health Workforce Roles in Accountable Care OrganizationsThis qualitative study draws on interviews with clinical staff to examine health workforce use within accountable care organizations and identifies common roles that support value-based care.
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Deprescribing in the Context of Multiple Providers: Understanding Patient PreferencesDeprescribing could reduce the risk of harm from inappropriate medications. Understanding patient attitudes regarding which clinicians can make deprescribing recommendations can facilitate effective design and implementation of interventions.
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Pilot of Urgent Care Center Evaluation for Acute Coronary SyndromeA formal protocol for urgent care center evaluation of potential acute coronary syndrome safely precluded emergency department visits among 84% of those eligible.
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Project ECHO: An Effective Means of Increasing Palliative Care CapacityThis article provides insight on the work of 7 of Project ECHO’s replicating partners from around the world who are implementing the ECHO model to address the knowledge gap that underlies integrated palliative care crisis.
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Impact of a Patient Incentive Program on Receipt of Preventive CarePatient financial incentives are a potential mechanism to improve health. In a South African health plan, a patient incentive program is associated with increased prevention.
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Effects of Telephone Counseling on Antipsychotic Adherence and Emergency Department UtilizationA telehealth nursing program used psychological counseling techniques to improve antipsychotic medication adherence, leading to reduced emergency department utilization in a managed Medicaid population.
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Comparison of Healthcare Delivery Systems in Low- and High-Income CommunitiesThis large-scale, national study shows geographic variation in provider supply and hospital access for low- and high-income communities following the Affordable Care Act.
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Patient-Centered Medical Home and Quality Measurement in Small PracticesSmall practices with NCQA patient-centered medical home recognition perform better on quality measures, especially those related to chronic conditions.
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Care Coordination to Increase Referrals to Smoking Cessation Telephone Counseling: A Demonstration ProjectAn intervention to increase tobacco treatment rates through care coordination for telephone counseling was effective in raising referral rates and in achieving excellent long-term abstinence.
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Effect of Management Strategies and Clinical Status on Costs of Care for Advanced HIVAntiretroviral drugs have replaced hospitalization and other services as the most costly component of HIV care, except in patients with especially advanced HIV.
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Risk Adjusting Medicare Advantage Star Ratings for Socioeconomic StatusThe National Committee for Quality Assurance urges socioeconomic risk adjustment to payments, not quality measures.
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Effectiveness and Cost-Effectiveness of Diabetes Prevention Among Adherent ParticipantsOver 10 years, among adherent participants, lifestyle intervention and metformin were effective and cost-effective for diabetes prevention compared with placebo.
