The American journal of managed care
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We analyzed the demographics and disease characteristics of patients prescribed treatment for chronic hepatitis C virus (HCV) infection from 2013 through 2017, a time frame that encompasses the expansion of available direct-acting antiviral inhibitors. ⋯ In the United States, since the introduction of interferon-free HCV regimens, the patient population prescribed treatment has changed, becoming predominantly treatment-naïve, without cirrhosis, and treated in nonacademic centers.
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To illustrate methods using administrative data on patients with diabetes that can offer a foundation for using network analyses in managed care. ⋯ Network analyses reveal structures and links that health plans could leverage to strengthen quality improvement and disease management programs.
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As the opioid epidemic has drawn increased attention, many researchers are attempting to estimate the financial burden of opioid misuse. These estimates have become particularly relevant as state and local governments have begun to take legal action against pharmaceutical manufacturers, distributors, and others who are identified as being potentially responsible for the worsening epidemic. ⋯ This article provides an overview and a conceptual framework for 2 types of labor market-related costs borne by state and federal governments that typically have not been incorporated into existing estimates, which may represent important categories of expenditures. Because detailed estimates of lost tax revenue are available elsewhere, this article focuses largely on whether, and how, to incorporate opioid-related expenses incurred by means-tested government programs into more general estimates of the economic harm created by the opioid epidemic.
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Physician satisfaction is associated with patient satisfaction, adherence to treatment recommendations, and quality. However, burnout is prevalent, and physician experience with health plans is likely a key contributor. We explored physician satisfaction with health plans and assessed physician and plan characteristics associated with greater satisfaction. ⋯ Our findings demonstrate opportunity to improve physician satisfaction with health plans, specifically in pharmacy/formulary management. As provider satisfaction is increasingly recognized as a critical outcome, our findings highlight intervention targets.
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The competing strategies of patient assistance programs and co-pay accumulator adjustment programs create confusion and administrative burden for clinicians and patients, potentially reducing adherence to clinically indicated services and worsening patient outcomes.