The authors examined 2 high-risk classification methods to compare and contrast the patient populations, and to identify the preferred method for predicting subsequent emergency department visits.
Physician assistants are increasingly valued in health services access and delivery. Missing from predictive modeling has been the retirement rate.
PQRS and GPRO encompass patient experience, chronic condition management, and population health arenas so that physician reimbursement can be tied to performance. The authors describe how to accurately improve your quality metrics.
Rural patients receive less postacute care after hospital discharge than urban patients, especially after elective joint replacement-a condition selected for bundled payments.
Analysis of insurance claims reveals that criteria other than the Healthcare Effectiveness Data and Information Set (HEDIS) persistent asthma definition can identify more at-risk patients with reasonable loss of specificity.
This randomized controlled trial finds that a hospital cesarean delivery rate comparison tool affects women’s perceptions but not where they choose to deliver.
Reference pricing is an effective cost-containment tool widely used in other countries; it may be an attractive policy strategy for the US healthcare system.
Human synthetic insulin may offer low-cost, effective treatment for certain patients with diabetes and financial constraints.
A 7.6% improvement in 12-month cholesterol refill was observed among US military veterans randomized to an adherence blister packaging intervention versus an education-only intervention.
Value-based payment improved fidelity to key elements of the Collaborative Care Model—an evidence-based mental health intervention—and improved patient depression outcomes in Washington state.
We observed small-area variation in computed tomography scan use for inpatients in New York State, even after controlling for relevant patient and hospital characteristics.
Significant changes were found in patients' utilization of healthcare related to early implementation of medical home components in VA primary care clinics.
An IVBM event cohosted by The American Journal of Managed Care focused on Healthy State, a multiyear, multistakeholder commitment to moving Louisiana ahead in America’s Health Rankings.
Using health insurance claims, we identified common first-, second-, and third-line chemotherapy regimens for patients with lung cancer and associated utilization and costs of care.
Economic incentives and patent protections drive development of innovative medications. Drug prices are determined by consumer demand, not production costs. Therefore, governmental regulation risks future investment in research and development.
From the Adult Diabetes and Clinical Research sections, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
This study demonstrates that common pharmacy claims-based measures underestimate the effect of actual adherence on inpatient costs among patients with serious mental illness.