Top 2017 AJMC® Articles Identify Ways to Reduce Costs and Improve Care Outcomes

With reimbursement increasingly tied to outcomes, health systems and practices are trying to find ways to reduce costs while delivering better care. Some of the most-read articles in The American Journal of Managed Care^® (AJMC^®) in 2017 included an analysis of the benefits of treating everyone with hepatitis C with new, expensive treatments, a program to reduce readmissions, and a look at the impact of value-based contracting in Medicare Advantage.

Here are the 5 most-read articles in AJMC^® in 2017.

5. Battling the Chargemaster: A Simple Remedy to Balance Billing for Unavoidable Out-of-Network Care

Patients who seek care from out-of-network providers face exorbitant charges, which place significant burdens on financially vulnerable patients. Authors in an April 2017 article identified state policies in place to combat the issue, but noted that they fall short. Instead, the authors wrote that rudimentary contract law can be a solution to the problem. Properly applying current contract law can bring an end to harmful chargemaster practices, the authors argued.

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4. State Prescription Drug Monitoring Programs and Fatal Drug Overdoses

With fatal prescription drug overdoses on the rise, an increasing number of states (more than 40) have implemented prescription drug monitoring programs (PDMPs) to maintain databases and monitor information on prescribing, dispensing, and purchasing of controlled substances. This May 2017 study examined the impact of PDMPs on drug overdose deaths.

However, the authors found that the programs were not associated with reductions in overall drug doses, and may actually be associated with an increased mortality from illicit drugs and other, unspecific drugs.

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3. Treating Medicaid Patients With Hepatitis C: Clinical and Economic Impact

The high cost of novel treatments for hepatitis C has led to many states implementing restrictive Medicaid policies that result in suboptimal outcomes and excess cost. In this February 2017 article, the authors took a look at the result of a “treat all” strategy, and found that it would result in reductions in downstream negative clinical outcomes, such as fewer cases of cirrhosis and liver transplants, and an estimated $3.8 billion in overall healthcare savings.

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2. Value-Based Contracting Innovated Medicare Advantage Healthcare Delivery and Improved Survival

The Medicare Advantage program offers an alternative to traditional fee-for-service Medicare with providers able to enter alternative payment models. Authors of a February 2017 study investigated how value-based contracting generates cost efficiencies and improves clinical outcomes. They found that value-based contracting can drive utilization patterns and improve clinical outcomes. Practice transformation into full-risk capitation resulted in a 6% survival benefit and lowered the hazard of death by 32.8%.

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1. Impact of a Pharmacy-Based Transitional Care Program on Hospital Readmissions

In this March 2017 article, authors analyzed the impact of a pharmacy-based transitional care program on reducing hospital readmissions. The healthy system identified hospitalized members who were at high risk for readmissions based on their prior healthcare utilization and a health risk assessment questionnaire. The pharmacist interventions focused on patient education, resolving medication-related problems, and facilitating access to postdischarge appointments and medications.

The program was able to reduce readmissions rates at 30 days by 28% and at 180 days by 31.9% compared with usual discharge care.

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