The American journal of managed care
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Letter Review Multicenter Study
How to optimize cancer therapy when coronavirus hits the fan.
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The American Journal of Managed Care® and Exact Sciences Corporation hosted a roundtable meeting to discuss the impact of colorectal cancer (CRC) screening modalities on improving patient outcomes. The roundtable participants were a diverse panel of experts, including primary care, gastroenterology, and oncology providers; experts in health outcomes research and health policy; and managed care executives with commercial and public payer experience. ⋯ Participants also provided suggestions on how to improve care quality and patient outcomes through effective evidence-based approaches. They also discussed costeffectiveness modeling for CRC screening, specifically the advantages and the real-world limitations of these models.
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Poorly defined measurement impairs interinstitutional comparison, interpretation of results, and process improvement in health care operations. We sought to develop a unifying framework that could be used by administrators, practitioners, and investigators to help define and document operational performance measures that are comparable and reproducible. ⋯ The FASStR framework can guide the design, development, and implementation of operational metrics in outpatient health care settings. Further, this framework can assist investigators in the evaluation of the metrics that they are using. Overall, the FASStR framework can result in clearer, more consistent use and evaluation of outpatient performance metrics.
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Observational Study
Value-based insurance design in Louisiana: Blue Cross Blue Shield's Zero Dollar Co-pay program.
To determine whether a program that eliminated pharmacy co-pays, the Blue Cross Blue Shield of Louisiana (BCBSLA) Zero Dollar Co-pay (ZDC) program, decreased health care spending. Previous studies have found that value-based insurance designs like the ZDC program have little or no impact on total health care spending. ZDC included an expansive set of medications related to 4 chronic diseases rather than a limited set of medications for 1 or 2 chronic diseases. Additionally, ZDC focused on the most at-risk patients. ⋯ The ZDC program provides evidence that value-based insurance designs that incorporate a comprehensive set of medications and focus on populations with chronic disease can reduce spending.
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Comparative Study
Measures of ED utilization in a national cohort of children.
Emergency department (ED) utilization is often used as an indicator of poor chronic disease control and/or poor quality of care. We sought to determine if 2 ED utilization measures identify clinically or demographically different populations of children. ⋯ The ED utilization measures identify clinically and demographically different groups of patients. Future studies should consider the medical complexity of the population being studied before choosing the most appropriate measure to employ.