September 2019

An evaluation of the Multi-Payer Advanced Primary Care Practice Demonstration found mixed results in terms of quality of care provided to Medicare and Medicaid beneficiaries.

Most patients in a large integrated healthcare system who were high-risk for hospitalization were at substantially lower risk within 2 years.

This study examines UnitedHealthcare’s Institutional Special Needs Plans and their association with hospital and skilled nursing facility use.

The authors studied Kansas Medicaid enrollees with serious mental illness and their experiences with integrated managed care and unmet needs.

Physician groups have begun designing alternative payment models for their own specialties, proposing that CMS include financial risk, funding for new technologies, and legal waivers.

Primary care teams reduced their prescribing of potentially inappropriate medications to older veterans after participation in the Veterans Affairs (VA) Geriatric Scholars Program.

Sociobehavioral phenotypes are actionable risk profiles based on empirically derived social, economic, and behavioral factors that, if applied appropriately, can help healthcare organizations address social determinants of health.

Transitioning from Medicaid fee-for-service to Medicaid managed care was associated with a significant decrease in ambulatory utilization, especially among beneficiaries with 5 or more chronic conditions.

Greater telephone wait times, but not abandonment rates, were associated with lower patient perceptions of their ability to obtain urgent care in a timely manner.

The Affordable Care Act’s reductions to Medicare Advantage plan payments were not significantly associated with healthcare access or affordability for enrollees.

Medicare Shared Savings Program accountable care organization (ACO) network comprehensiveness is associated with stable patient assignment year to year. Panel stability was significantly associated with improved diabetes and hypertension control in the short term.