The American journal of managed care
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To develop a strategy to promote life satisfaction with equity for a diverse insured population. ⋯ The most effective strategy to promote both overall life satisfaction and equity will address social determinants for members with unmet social needs, provide the behavioral and mental health services that benefit members with these needs, and promote healthy lifestyles with an emphasis on healthy thinking for the entire population.
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Innovative value strategies for reimbursement of medications include value-based agreements (VBAs) between payers and pharmaceutical manufacturers, which have the potential to improve affordability and patient access to therapy, as well as lead to a reduction in downstream health events and associated medical costs. VBAs link payment for a medication to its performance in real-world clinical practice measured against prespecified outcomes that are aligned to existing evidence. ⋯ Between 2015 and 2018, 11 contract-years of VBAs utilizing this framework were implemented in commercial and Part D health insurance plans, totaling nearly 32,000 unique patients in which pooled analyses were conducted. Aggregated VBA results indicate that ticagrelor consistently outperformed expectations in reducing recurrent MI vs clopidogrel, while also illustrating how comparative VBA frameworks of this nature may overcome challenges noted for VBAs and be utilized more broadly in future applications.
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To assess the association of geriatric syndrome risk factors with postacute utilization among hospitalized Medicare patients (both Medicare Advantage [MA] and fee-for-service [FFS] cohorts) and to examine patterns of postacute care for MA and FFS cohorts with high geriatric syndrome risk. ⋯ Geriatric syndrome risk factors not only play a role in postacute care and inpatient utilization in MA and FFS cohorts but also explain different utilizations between MA and FFS cohorts. This study's results can be applied to guide discharge planning among a group of high-risk patients and evaluate alternative delivery models for this high-cost, high-need cohort.
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Parkinson disease affects nearly 1 million people in the United States, and the prevalence is expected to increase to at least 1.2 million people by 2030. Parkinson disease is a chronic, incurable disease. ⋯ People with Parkinson disease who experience OFF periods and their caregivers have reported more work days with low productivity and more missed work days compared with those who do not experience OFF periods. More caregivers of people with Parkinson disease who experience OFF episodes reported that due to the disease, they had reduced or changed working hours, lost opportunities, or had reduced work productivity, and these caregivers reported an average of more than twice the amount of employment income lost compared with caregivers of people with Parkinson disease who do not experience OFF periods.
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COVID-19 has created a significant distraction from normal practice operations. The uncertainty that comes along with the pandemic is a huge worry, and can distract from practice transformation.