The American journal of managed care
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Individuals with multiple chronic conditions (MCCs) represent a growing proportion of the adult population in the United States, particularly among lower-income individuals and people of color. Despite ongoing efforts to characterize this population and develop approaches for effective management, individuals with MCCs continue to contribute substantially to health care expenditures. Based on a review of recent literature, several identified barriers limit the effectiveness of care for patients with MCCs. ⋯ The COVID-19 pandemic has shed further light on inequities contributing to suboptimal MCC patient management. Awareness of the prevalence and demographic attributes of patients with MCCs and the identified barriers to care may help improve patient engagement and treatment outcomes for this high-cost population. This paper provides recommendations for enhancing MCC patient care outcomes in the current and post-COVID-19 health care delivery settings.
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Observational Study
Hospital outcomes of male breast cancer in the United States.
Hospital utilization and costs of female breast cancer have been well documented. However, evidence focusing on male breast cancer is scarce, despite the different clinical characteristics between female and male breast cancer. We aim to estimate hospital length of stay (LOS) and costs associated with male breast cancer in the United States. ⋯ LOS and hospital costs for male patients with breast cancer were associated with metastatic status and comorbidities. This information can be used to assess the health care resources needed to treat male breast cancer.
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As American clinicians have tried to reduce heart failure rehospitalizations and improve care for patients with heart failure with reduced ejection fraction (HFrEF), the population of patients who have heart failure with preserved ejection fraction (HFpEF) has emerged as needing attention. Although HFrEF and HFpEF share some characteristics, treatment approaches are different, and treatment options for HFpEF are more limited. All patients would benefit from guideline-directed medical treatment. ⋯ In addition, investigators are examining possible uses of omecamtiv mecarbil and nonsteroidal aldosterone antagonists in heart failure. Addressing heart failure is a team effort, and such teams need overlapping expertise, innovative approaches, and resources that support and sustain their efforts. Team members should familiarize themselves with the American College of Cardiology 2021 Update to the 2017 Expert Consensus Decision Pathway as a means to offer the best care to the patients that they serve.
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The United States has an increasing number of patients with heart failure (HF) who experience significant disease burden as well as contribute to high economic healthcare costs and usage of healthcare resources. HF costs are currently estimated at $30.7 billion. If no improvements are made to current treatment outcomes, it is expected to grow to $69.8 billion by the year 2030. ⋯ These mixed program outcomes show the importance of evaluating HF-related transitional care program components for future directions. Newly approved treatments for HF with preserved ejection fraction may improve clinical outcomes for these patients. Pharmacists and physicians can help improve access to HF medications by assisting patients on how to navigate manufacturer assistance programs, submitting complete and well-supported prior authorization forms when needed, and encouraging the use of pharmacy price matching and price checkers.
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Observational Study
Association between hospital-insurer contract structure and hospital performance.
To describe the association between the form of hospitals' contracts-either markup from a benchmark or a discount from a list price-and performance: price, charge, cost, and length of stay. ⋯ Limited research exists on the relationship between contract structure and hospital performance. Our results suggest that hospital performance is related to contract structure, possibly due to factors such as differences in bargaining strategies or ex post incentives.