The American Journal of Managed Care This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Nurse practitioner low-value care ordering practices: an integrative review
CONCLUSIONS: The full extent to which NPs order LVC services, as well as a comprehensive understanding of the factors influencing their decisions, remains unknown. It is unclear whether NPs order fewer or equal LVC services compared with other health care clinicians. More research on NPs and LVC is indicated.PMID:38457828 | DOI:10.37765/ajmc.2024.89520 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - March 8, 2024 Category: Health Management Authors: Sara B Nugent Roberta P Lavin Barbara I Holmes Damron Source Type: research

Out-of-pocket costs for diabetes medications in employer-sponsored health insurance plans
Am J Manag Care. 2024 Mar;30(3):107-108. doi: 10.37765/ajmc.2024.89510.ABSTRACTOut-of-pocket costs of diabetes medications other than insulin can be quite high for individuals with employer-sponsored health insurance.PMID:38457817 | DOI:10.37765/ajmc.2024.89510 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - March 8, 2024 Category: Health Management Authors: Jennie Quach Cody Midlam Chantell Sell Jeff Levin-Scherz Source Type: research

Addressing patients' unmet social needs: checklists are a means, trust is foundational
Am J Manag Care. 2024 Mar;30(3):110-113. doi: 10.37765/ajmc.2024.89511.ABSTRACTIdentifying and addressing unmet social needs without attention to other contributors to health inequities-such as medical mistrust-is unlikely to yield desired outcomes.PMID:38457818 | DOI:10.37765/ajmc.2024.89511 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - March 8, 2024 Category: Health Management Authors: Bruce W Sherman A Mark Fendrick Source Type: research

Cost sharing for oral lenvatinib among commercially insured patients
CONCLUSIONS: In this cohort, insurance was liable for the majority of total lenvatinib drug costs, and 75% of patients paid $100 or less per month out of pocket. This information can be used by care teams to counsel insured patients. Health systems and drug manufacturers must identify patients with high out-of-pocket costs and provide convenient access to financial assistance programs so that patients are not forced to forgo the benefits of these drugs due to financial barriers. Value-based payment models and drug pricing reform are also needed to address underlying drivers of high drug costs.PMID:38457819 | DOI:10.37765/a...
Source: The American Journal of Managed Care - March 8, 2024 Category: Health Management Authors: Margaret I Liang Ling Chen Emeline M Aviki Jason D Wright Source Type: research

Insurer costs of COVID-19 by disease severity and duration
CONCLUSIONS: COVID-19 payments for S/C cases were more than 10-fold greater than those of moderate cases and further increased by nearly $95,000 in S/C cases with PCC vs a DOD of fewer than 4 weeks.PMID:38457820 | DOI:10.37765/ajmc.2024.89513 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - March 8, 2024 Category: Health Management Authors: Chantal E Holy Brandon J Patterson Jill W Ruppenkamp Fayolah Richards Ronita Debnath Antoine C El Khoury Jessica K DeMartino Brahim Bookhart Paul M Coplan Source Type: research

Evaluation of a collaborative model between managed care and affordable housing on acute care costs
CONCLUSIONS: These findings provide needed evidence of the clinical and economic value of forming multisector collaborative models between MCOs and other community providers.PMID:38457821 | DOI:10.37765/ajmc.2024.89514 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - March 8, 2024 Category: Health Management Authors: Jack Tsai Suja Rajan Chau Truong Vanessa Schick Cecilia Ganduglia Cazaban Source Type: research

Challenges of fracture risk assessment in Asian and Black women
CONCLUSIONS: A large subset of Asian women have discordant BMD and FRAX scores, presenting challenges in osteoporosis management. Furthermore, FN-BMD and especially FRAX scores identified few Black women at high fracture risk warranting treatment. Studies should examine whether fracture risk assessment can be optimized in understudied racial minority populations, particularly when findings are discordant.PMID:38457822 | DOI:10.37765/ajmc.2024.89515 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - March 8, 2024 Category: Health Management Authors: Joan C Lo Malini Chandra Wei Yang Nailah Thompson Catherine Lee Mohan Ramaswamy Mehreen Khan Amber Wheeler Source Type: research

Increased Medicare payments for homeless patients provide new opportunities for care
Am J Manag Care. 2024 Mar 1;30(3):e63-e64. doi: 10.37765/ajmc.2024.89516.ABSTRACTA final rule has been issued that increases Medicare fee-for-service payment rates for individuals experiencing homelessness. This rule provides new, incentivized opportunities to better screen for and document homelessness among patients in acute inpatient settings. With greater identification of homeless patients, there may be increased needs to develop comprehensive discharge plans that involve coordination with housing providers and social service agencies to prevent the high repeated use of acute care found among many homeless patients.PM...
Source: The American Journal of Managed Care - March 8, 2024 Category: Health Management Authors: Jack Tsai Source Type: research

Inappropriate wrist MRI: did guidelines have an impact?
CONCLUSIONS: MRI as a diagnostic tool for wrist pain is often inappropriate and expensive. Our findings support interventions to increase guideline adherence, such as integrated clinical decision support tools.PMID:38457824 | DOI:10.37765/ajmc.2024.89517 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - March 8, 2024 Category: Health Management Authors: Trista M Ben ítez Meghan N Cichocki Weijia Jin Anne V Seyferth Lu Wang Kevin C Chung Erika D Sears Source Type: research

At-home hemoglobin A1c testing during COVID-19 improved glycemic control
CONCLUSIONS: This novel, at-home approach to test HbA1c is an effective intervention to increase testing rates and facilitate HbA1c reduction over time in patients with T2D.PMID:38457825 | DOI:10.37765/ajmc.2024.89449 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - March 8, 2024 Category: Health Management Authors: Lauren C LaMonica Jingwei Ren Nina Jain Eli S Goldberg Kyu B Rhee Paige Wickner Sreekanth K Chaguturu Source Type: research

Improving glycemic control in diabetes through virtual interdisciplinary rounds
CONCLUSIONS: Interdisciplinary rounds can be an effective approach to proactively provide diabetes-focused recommendations. This modality allows for efficient, low-cost, and timely access to an endocrinologist and team to support primary care providers in diabetes management.PMID:38457826 | DOI:10.37765/ajmc.2024.89518 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - March 8, 2024 Category: Health Management Authors: Abby F Hoffman Cindy Leslie Roberson Pamela Cohen Victoria Lee Jackson John Yeatts Patrick Gregory Samantha Wong Susan E Spratt Source Type: research

The extent and growth of prior authorization in Medicare Advantage
CONCLUSIONS: In 2019, roughly 3 in 4 MA enrollees were in a plan requiring prior authorization. Service-level, area-level, and carrier-level patterns suggest a wide range of approaches to prior authorization requirements.PMID:38457827 | DOI:10.37765/ajmc.2024.89519 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - March 8, 2024 Category: Health Management Authors: Hannah T Neprash John F Mulcahy Ezra Golberstein Source Type: research