The American journal of managed care
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To evaluate changes in health care spending and utilization associated with a telehealth-based care coach-supported and behavioral health (BH) provider referral intervention in the United States. ⋯ Although the results could be affected by unmeasured confounding, they suggest that care coaching interventions that offer BH provider referrals may produce long-term savings, reductions in avoidable utilization, and increases in targeted services to treat BH conditions. Rigorous evaluations are needed to confirm these findings.
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Curative direct-acting antivirals for chronic hepatitis C provide a net economic benefit to Medicaid in less than 1 year. Cumulative savings to date have exceeded $15 billion.
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The American Medical Association recognized obesity as a disease in 2013. Obesity is influenced by genetic, environmental, physiologic, behavioral, and sleep factors and is associated with approximately 200 health conditions. ⋯ Nevertheless, there are substantial barriers to successful obesity treatment in the United States, including inadequate treatment coverage; a lack of acceptance by providers, patients, and employers that obesity is a disease; the perception that treatment is ineffective; and the belief that obesity is a behavioral concern related to a lack of willpower. Obesity is a serious, chronic, relapsing, and treatable disease associated with many related conditions; it requires long-term medical management and multimodal care strategies.
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Hospitals must strategically build organizational capacities to succeed in bundled payment arrangements. Given differences between Medicare and commercial arrangements, capacities may vary between hospitals in Medicare vs both Medicare and commercial bundled payment programs. This study compared organizational capacities between these 2 hospital groups. ⋯ Although they have similar capacity in a number of areas, Medicare-only and multipayer hospitals differed with respect to other aspects of organizational capacity.
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With the rise in the population of older adults, the number of individuals living with chronic diseases that need management will increase dramatically. Successful programs have been developed for chronic conditions (eg, heart failure, diabetes, asthma, chronic obstructive pulmonary disease) that use principles of self-management, monitoring, and care coordination. However, because of the effects of dementia on the mind including behavioral complications, the progressive loss of capacity for affected individuals to participate in care or decision-making, the devastating effects on care partners, and the scope of disease management beyond medical issues, the management of dementia is different and demands different approaches. The success of dementia management will depend upon how well the care provided is able to maximize the function, independence, and dignity of the individual living with dementia while minimizing care partner strain and burnout.