The American journal of managed care
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To examine differences in the out-of-pocket costs for common generic drugs used to treat chronic conditions when individuals used their Medicare prescription drug plan (PDP) or when purchased through Walmart's generic drug discount programs (GDDPs) from 2009 to 2017. ⋯ Although Medicare beneficiary out-of-pocket costs for commonly used generic drug prescriptions generally decreased over time, Medicare beneficiaries may still be paying more for the same drugs than they would through Walmart's GDDP. Increased generic drug price transparency, including enforcing bans on gag clauses, is needed to ensure that Medicare beneficiaries obtain drugs using the most affordable options.
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Observational Study
Care management reduced infant mortality for Medicaid managed care enrollees in Ohio.
In 2012, the Ohio Department of Medicaid introduced requirements for enhanced care management to be delivered by Medicaid managed care organizations (MCOs). This study evaluated the impact of care management on reducing infant mortality in the largest Medicaid MCO in Ohio. ⋯ This study provides evidence that care management can be effective in reducing infant mortality among Medicaid MCO enrollees, a population at high risk of mortality. Few infants were engaged in care management, suggesting to policy makers that there is room for many additional infants to benefit from this intervention.
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Multicenter Study
Patient outcomes associated with tailored hospital programs for intellectual disabilities.
Hospitals have begun designing programs tailored to patients with intellectual disabilities to address their specific healthcare needs and social determinants of health. This study aimed to determine whether these programs improve hospital outcomes for patients with intellectual disabilities. ⋯ Providing tailored programs for patients with intellectual disabilities is a promising strategy for improving inpatient care for this population.
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The Veterans Health Administration (VHA) is adapting to a new model of care in the wake of the Veterans Choice Act of 2014. A longitudinal study, The Veterans Metrics Initiative, captured multiple domains of psychosocial health and healthcare use as veterans moved through the first 15 months of transition from military to civilian life. This study examined gender differences and clinical, social, and lifestyle correlates in healthcare use. ⋯ US veterans separating from military service need expert care, both in the VHA and elsewhere, for anxiety, depression, and sleep disturbance. Women veterans may be underserved by the VHA and may benefit from housing assistance programs to enable ongoing healthcare use.
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To examine whether mental health conditions, opioid use, and medication nonadherence are associated with inpatient and emergency department (ED) use among Medicare super-utilizers from medically underserved areas. ⋯ The study findings highlight the importance of improving medication adherence and addressing behavioral health needs in Medicare super-utilizers.