The American journal of managed care
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To measure adherence and assess medical utilization among employees enrolled in a disease management (DM) program offering copayment waivers (value-based insurance design [VBID]). ⋯ VBID may be effective in improving medication adherence and reducing total healthcare costs when active counseling is provided to high utilizers of care.
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To estimate the economic value of screening pregnant women for Staphylococcus aureus carriage before cesarean delivery. ⋯ Despite high rates of cesarean delivery, presurgical screening of pregnant women for S aureus and decolonization of carriers is unlikely to be cost-effective under prevailing epidemiologic circumstances.
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Unintended consequences may result from changes in pharmacy benefit design. The objective was to determine the impact of increasing patient prescription copayments for guideline recommended, long-term asthma controller (LTC) medications on asthma-related medication use and healthcare services. ⋯ The findings suggest that even small changes in average copayment for asthma medications can result in significant reductions in medication use and unintended increases in healthcare services.
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To determine the 2-year impact of high-deductible health plans (HDHPs) on high-acuity, expensive medical care. ⋯ HDHP members experienced sustained reductions in emergency department visits over 2 years, but reductions in hospital utilization and costs were not apparent by the second year. Longer-term studies that assess deferred utilization and its effects are needed.