August 2021

Disease burden estimates of pneumonia-associated hospitalizations are more sensitive when including pneumonia coded in any diagnosis field vs in only the first discharge diagnosis field.

Adding a sodium-glucose co-transporter 2 (SGLT2) inhibitor dominated switching to a glucagon-like peptide 1 receptor agonist over the lifetimes of patients with type 2 diabetes not at glycated hemoglobin A1c target after treatment with metformin plus a dipeptidyl peptidase-4 inhibitor.

This article presents a cost-effectiveness analysis of nivolumab vs docetaxel from the US payer perspective in non–small cell lung cancer (NSCLC) based on randomized phase 3 studies with a minimum 5 years of follow-up.

This article provides a description of prospective financial simulation methodology and use cases with empirical data for episode-based bundled payments, including implications for contract negotiations and value-based care redesign.

Although previous work has found lower costs for biosimilar filgrastim compared with reference filgrastim, this study found that site of care can change this calculus, reducing savings.

Mortality risk stratification can identify patients with COVID-19 who are at higher risk of mortality, discharge to skilled nursing facility, and readmission, and may benefit from focused intervention strategies.

This study provides the first evidence on how Marketplace insurers are altering their marketing in response to changes in competitive pressure over time.

Schizophrenia, chronic pain, and multiple medical diagnoses at enrollment into a large managed Medicaid system are associated with long-term high health care utilization.

Provision of enhanced access to behavioral health services by a large employer to its employees is associated with reductions in all-cause care utilization and cost.

This study shows little evidence of harms or increased health care utilization for people receiving negative (normal) results of expanded carrier screening through genome sequencing.

After years of anticipation, Amazon Pharmacy launched in November 2020. The question is now: Is this market entry a disruption, a distraction, or something in between?

The No Surprises Act represents a rare bipartisan moment for Congress and a long-needed safeguard for patients that will reorient relationships among payers and providers.

This article describes a recently finalized CMS rule addressing the permissibility of co-pay accumulator adjustment programs (CAAPs) when no generic is available.