Physician prices and low-value services: evidence from general internal medicine
CONCLUSIONS: Commercially insured patients of high-priced physicians received fewer low-value services, although spending on low-value services was higher. More research is needed to understand why high-priced providers deliver fewer low-value services and whether physician prices are correlated with other measures of quality.PMID:35546591 | DOI:10.37765/ajmc.2022.89149 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - May 13, 2022 Category: Health Management Authors: Amelia M Bond Yongkang Zhang Fabrizio Toscano Manyao Zhang Phyllis Johnson Yuting Qian Mark Aaron Unruh Lawrence P Casalino Source Type: research

Characteristics of home-based care provided by accountable care organizations
CONCLUSIONS: ACOs deliver a diverse array of home-visit services including primary care, acute medical care, palliative care, care transitions, and interventions to address social determinants of health. Many services provided are not billable, and therefore ACO leaders are hesitant to fund expansions without strong evidence of ROI. Expanding Medicare ACO home-visit waivers to all risk-bearing ACOs and covering integrated telehealth services would improve the financial viability of these programs.PMID:35546592 | DOI:10.37765/ajmc.2022.89150 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - May 13, 2022 Category: Health Management Authors: Robert E Mechanic Jennifer Perloff Amy R Stuck Christopher Crowley Source Type: research

Impact of co-pay assistance on patient, clinical, and economic outcomes
CONCLUSIONS: Limited evidence suggests a potential link between co-pay assistance and clinical outcomes; future research addressing study design challenges in measuring the effects of co-pay assistance is needed.PMID:35546593 | DOI:10.37765/ajmc.2022.89151 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - May 13, 2022 Category: Health Management Authors: Krupa D Parekh William B Wong Leah L Zullig Source Type: research

Improving care coordination and reducing ED utilization through patient navigation
CONCLUSIONS: Our program demonstrates that high-intensity, short-term patient navigation in the ED can help reduce ED visits in those with low baseline ED utilization and facilitate stronger connections with primary care.PMID:35546582 | DOI:10.37765/ajmc.2022.89140 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - May 13, 2022 Category: Health Management Authors: Salina Bakshi Lucas C Carlson Joy Gulla Priscilla Wang Kristy Helscel Brian J Yun Christine Vogeli Amy O Flaster Source Type: research

Patterns of opioid use in commercially insured patients with cancer
CONCLUSIONS: Fewer than half of patients received opioids in the 2 years following cancer onset. Among users, we found a relatively small proportion of potentially problematic opioid use. Further research is warranted to assess the adequacy of cancer pain treatment and determinants of high-risk opioid use.PMID:35546583 | DOI:10.37765/ajmc.2022.89141 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - May 13, 2022 Category: Health Management Authors: Tham Thi Le Sean P Fleming Linda Simoni-Wastila Source Type: research

Primary care practice structural capabilities in health professional shortage areas
CONCLUSIONS: Expanding care coordination may be beneficial for HPSA populations with high rates of morbidity and socioeconomic needs. Future research is needed to understand how the NP workforce may be optimized to meet the growing primary care demands in underserved areas.PMID:35546584 | DOI:10.37765/ajmc.2022.89142 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - May 13, 2022 Category: Health Management Authors: Ani Bilazarian Grant Martsolf Amelia E Schlak Vaneh Hovsepian Jianfang Liu Lusine Poghosyan Source Type: research

The relationship between provider age and opioid prescribing behavior
CONCLUSIONS: Assuming that older physicians follow patterns of previous generations, anticipated retirement of older providers and entry by younger providers will tend to reduce opioid volumes, undoing at least in part the rapid increase since 2000.PMID:35546585 | DOI:10.37765/ajmc.2022.89143 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - May 13, 2022 Category: Health Management Authors: Laurence C Baker Daniel P Kessler Grant K Vaska Source Type: research

Rising use of surveillance colonoscopy and potential impacts
CONCLUSIONS: Guidelines should make clear recommendations about when and how to discontinue postpolypectomy surveillance colonoscopy. Doing so would potentially reduce harms due to complications from low-value procedures and in turn moderate demand and thereby enhance overall procedural access for patients more likely to benefit.PMID:35546586 | DOI:10.37765/ajmc.2022.89143 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - May 13, 2022 Category: Health Management Authors: Megan A Adams Joel H Rubenstein Rob Holleman Rachel Lipson Mandi L Klamerus Shannon Zoulek Sameer D Saini Source Type: research

Patients' needs following emergency care for ambulatory care-sensitive conditions
CONCLUSIONS: More than half of patients with treat-and-release ED visits for chronic ACSCs have recommended medication changes, and two-thirds have at least 1 follow-up care need. This information offers potential foci for testing interventions to improve care coordination for patients with ACSCs who are released from the ED.PMID:35546587 | DOI:10.37765/ajmc.2022.89145 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - May 13, 2022 Category: Health Management Authors: Kristina M Cordasco Anita H Yuan Kymberly Aoki David A Ganz Source Type: research

Evaluating alternative methods of comparing antihypertensive treatment intensity
CONCLUSIONS: Measuring change in antihypertensive treatment using medication count frequently missed an isolated dose change in treatment modification and less often misclassified regimen modifications where there was no modification in total dose. In future research, measuring dose modification using our new algorithm would capture change in hypertension treatment intensity more precisely than current methods.PMID:35546588 | DOI:10.37765/ajmc.2022.89146 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - May 13, 2022 Category: Health Management Authors: Carole E Aubert Chiao-Li Chan Samuel W Terman Timothy P Hofer Jin-Kyung Ha William C Cushman Jeremy Sussman Lillian Min Source Type: research

Assessing surveillance utilization and value in commercially insured patients with colorectal cancer
CONCLUSIONS: Higher intensity of surveillance, beyond what is recommended by guidelines, may lead to earlier recurrence detection and subsequent treatment, but this is associated with significantly higher direct medical costs.PMID:35546589 | DOI:10.37765/ajmc.2022.89147 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - May 13, 2022 Category: Health Management Authors: Kangho Suh Veena Shankaran Aasthaa Bansal Source Type: research

Disparities in health care use among low-salary and high-salary employees
CONCLUSIONS: Low-salary employees enrolled in HDHPs have higher rates of acute care utilization and spending but lower rates of primary care spending compared with high-salary employees. Results suggest that HDHPs discourage routine physician-patient care among low-salary employees.PMID:35546590 | DOI:10.37765/ajmc.2022.89148 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - May 13, 2022 Category: Health Management Authors: Benjamin Ukert Stephen Esquivel-Pickett Manish Oza Andrea DeVries Gosia Sylwestrzak Source Type: research

Physician prices and low-value services: evidence from general internal medicine
CONCLUSIONS: Commercially insured patients of high-priced physicians received fewer low-value services, although spending on low-value services was higher. More research is needed to understand why high-priced providers deliver fewer low-value services and whether physician prices are correlated with other measures of quality.PMID:35546591 | DOI:10.37765/ajmc.2022.89149 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - May 13, 2022 Category: Health Management Authors: Amelia M Bond Yongkang Zhang Fabrizio Toscano Manyao Zhang Phyllis Johnson Yuting Qian Mark Aaron Unruh Lawrence P Casalino Source Type: research

Characteristics of home-based care provided by accountable care organizations
CONCLUSIONS: ACOs deliver a diverse array of home-visit services including primary care, acute medical care, palliative care, care transitions, and interventions to address social determinants of health. Many services provided are not billable, and therefore ACO leaders are hesitant to fund expansions without strong evidence of ROI. Expanding Medicare ACO home-visit waivers to all risk-bearing ACOs and covering integrated telehealth services would improve the financial viability of these programs.PMID:35546592 | DOI:10.37765/ajmc.2022.89150 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - May 13, 2022 Category: Health Management Authors: Robert E Mechanic Jennifer Perloff Amy R Stuck Christopher Crowley Source Type: research

Impact of co-pay assistance on patient, clinical, and economic outcomes
CONCLUSIONS: Limited evidence suggests a potential link between co-pay assistance and clinical outcomes; future research addressing study design challenges in measuring the effects of co-pay assistance is needed.PMID:35546593 | DOI:10.37765/ajmc.2022.89151 (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - May 13, 2022 Category: Health Management Authors: Krupa D Parekh William B Wong Leah L Zullig Source Type: research