Issues of Medical Necessity: A Medical Director's Guide to Good Faith Adjudication

To achieve longer accountable relationships, a bridge from one insurer to another could be built through continuity of accountability amid insurance transitions, improved risk prediction, and cooperation in the design of accountable care models.

Adults currently aging into Medicare utilized counseling and psychotherapy services at higher rates than those in prior cohorts at the same age.

Care delivery innovations to help patients with cancer avoid emergency department visits are underused. The authors interviewed English- and Spanish-preferring patients at 2 diverse health systems to understand why.

Emergency department (ED) visits and hospitalizations for ambulatory care–sensitive conditions (ACSCs) among Medicaid patients constitute almost 40% of all ED visits and hospitalizations, with lower rates observed in areas with greater proximity to urgent care facilities and density of rural health clinics.

This article used regression analyses to quantify how clinical staff perceive provider feedback to improve human papillomavirus (HPV) vaccination rates and determine the prevalence of such feedback.

This survey assesses physician experiences with utilization management and burnout and investigates whether there is a link between them.