The American journal of managed care
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Most patients receiving multimodality cancer care receive care from different practices. Therefore, episode-based payments in oncology must hold multiple providers accountable for costs and quality.
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Early detection of disease enables prompt treatment that can prevent disease progression and costly health outcomes. We report incidence of previously unrecognized disease and investigate the expected effect of early detection and care on health outcomes. ⋯ Early identification and appropriate medical care may delay 34 cases of end-stage kidney disease and prevent diabetes-related complications, 210 cases of diabetes, and 3 cases of late-stage colorectal cancer over 5 years per 1000 cases identified.
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Comparative Study
Multipayer primary care transformation: impact for Medicaid managed care beneficiaries.
To evaluate the effects of Michigan Primary Care Transformation (MiPCT), a statewide multipayer patient-centered medical home (PCMH) demonstration in 2012-2015, on cost, utilization, and quality among Medicaid managed care beneficiaries. ⋯ Evidence of cost savings exists among MiPCT Medicaid managed care adults; it was driven by high-risk adults, who also had reduced hospitalization risk. For children, no cost reductions occurred, but hospital and ED utilization were reduced in 2015. MiPCT maintained equal or higher quality of care but did not show consistent improvement.
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To (1) examine the impact of the Comprehensive Health Management Patient Service (CHaMPS) on unplanned hospital admissions and emergency department (ED) visits in patients with chronic conditions, (2) describe the number and type of pharmacist interventions, and (3) determine the cost savings of CHaMPS. ⋯ CHaMPS achieved its goals by demonstrating a positive impact on ED visits and a benefit-cost ratio greater than 1.0. The cost savings of the embedded pharmacist model are most beneficial from a payer perspective or an accountable care organization approach to healthcare.
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Laying a clear path for incorporating reliable evidence on heterogeneity in value assessments could improve their applicability for healthcare decision making.