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Digital musculoskeletal program is associated with decreased joint replacement rates
CONCLUSIONS: These findings suggest that patients who participated in a digital MSK program to manage OA have lower rates of total joint arthroplasty in the 12 months after enrollment.PMID:38603535 | DOI:10.37765/ajmc.2024.89463 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - April 11, 2024 Category: Health Management Authors: Louie Lu Laura S Gold Karl M Koenig Jonathan H Lee Grace Wang Source Type: research

Office procedures for older adults by physician associates and nurse practitioners
CONCLUSIONS: Overall, PAs performed more skin and musculoskeletal procedures than NPs, and NPs performed more procedures in the other 7 procedure clusters than PAs. PA and NP employment growth does not fully explain these observations. We suggest that outpatient procedural task-shifting activity presents an area for further research.PMID:38603536 | DOI:10.37765/ajmc.2024.89532 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - April 11, 2024 Category: Health Management Authors: Robert E McKenna Roderick S Hooker Robert Christian Source Type: research

Impact of care coordination on 30-day readmission, mortality, and costs for heart failure
CONCLUSIONS: High care coordination is associated with decreased 30-day readmission, mortality, and costs for HF. Enhancing coordination of care has the potential to increase the value of care. It is important to monitor coordination of care and develop strategies to maintain high levels of care coordination for HF.PMID:38603537 | DOI:10.37765/ajmc.2024.89533 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - April 11, 2024 Category: Health Management Authors: Guann-Ming Chang Yu-Chi Tung Source Type: research

Medication persistence and its impact on type 2 diabetes
CONCLUSIONS: Our findings show low persistence among patients with T2D and emphasize the importance of medication persistence, which is associated with cost savings and lower risk of hospitalizations.PMID:38603538 | DOI:10.37765/ajmc.2024.89534 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - April 11, 2024 Category: Health Management Authors: Jee H Choe Si Xuan Antony Goldenberg Jacqueline Matian Jeff McCombs Rory E Kim Source Type: research

Institutional practices for charitable medication access for uninsured patients
CONCLUSIONS: Overall, this study was able to characterize patient demographics, historical costs related to charitable care coverage, and the utilization of health care services among this population. This information can be used to support the development and implementation of a charitable medication formulary, with the aims of improving quality of care for this population and reducing medical center costs.PMID:38603539 | DOI:10.37765/ajmc.2024.89535 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - April 11, 2024 Category: Health Management Authors: Akshara Kumar Caitlin Dowd-Green Robert Green Rosalyn Stewart Source Type: research

Safety vs price in the generic drug market: metformin
CONCLUSIONS: Recalls of metformin ER medications were effective in lowering NDMA levels below the FDA threshold; however, some samples of generic metformin still contained carcinogens even after FDA-announced recalls. The absence of any correlation with price indicates that potentially safer products are available on the market for the same price as poorer-quality products.PMID:38603530 | DOI:10.37765/ajmc.2024.89450 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - April 11, 2024 Category: Health Management Authors: Ben Teasdale Amber Hudspeth Kaury Kucera David Light Jill Nailor Shannon Williams Arnold Milstein Kevin A Schulman Source Type: research

High-need beneficiary enrollment patterns in Medicare Advantage and traditional Medicare
CONCLUSIONS: We found that high-need beneficiaries were more likely to be in TM non-ACOs than in MA through 2019. However, an increasing number of these beneficiaries are enrolling in MA or aligned with a TM ACO. A projected increase in the population of older adults will increase the economic burden of caring for high-need individuals.PMID:38603531 | DOI:10.37765/ajmc.2024.89528 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - April 11, 2024 Category: Health Management Authors: Aig Unuigbe Inna Cintina Julia Sheriff Lane Koenig Source Type: research

Prices and complications in hospital-based and freestanding surgery centers
CONCLUSIONS: The higher prices charged in HOPDs for the 3 ambulatory procedures were not balanced by better quality-as measured by rates of procedural complications-compared with procedures performed in nonhospital ASCs.PMID:38603532 | DOI:10.37765/ajmc.2024.89529 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - April 11, 2024 Category: Health Management Authors: James C Robinson Christopher M Whaley Sanket S Dhruva Source Type: research

Trends in low-value cancer care during the COVID-19 pandemic
CONCLUSIONS: Low-value cancer care remained prevalent throughout the pandemic. Policy makers should consider changes to payment and incentive design to turn the tide against low-value cancer care.PMID:38603533 | DOI:10.37765/ajmc.2024.89530 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - April 11, 2024 Category: Health Management Authors: Ravi B Parikh Yasin Civelek Pelin Ozluk David Debono Michael J Fisch Gosia Sylwestrzak Justin E Bekelman Aaron L Schwartz Source Type: research

Adjusting starting points for initial price offers: the example of ibrutinib
This article focuses on the data obtained for ibrutinib, an oral medication for treating hematologic malignancies, which is one of the only drugs reviewed by the committee that also has been selected for Medicare price negotiation. We examine data that can be obtained only from the drug manufacturer that the IRA has explicitly identified as being used to determine the price and suggest potential negotiation strategies for CMS in response.PMID:38603534 | DOI:10.37765/ajmc.2024.89531 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - April 11, 2024 Category: Health Management Authors: Jason B Gibbons Charles L Bennett Kenneth R Carson Gerard F Anderson Source Type: research