The American journal of managed care
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The authors examine the origin, benefits, and challenges of pragmatic clinical trials to assess the ultimate value of this research design.
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The estimated global prevalence of chronic cough (CC) is close to 10%; however, this is likely higher, as many epidemiologic surveys do not adequately capture symptoms or diagnoses of CC. There is a large healthcare burden associated with CC as well as decreased quality of life (QOL). CC has previously been considered a symptom of other comorbidities. ⋯ Identified gaps in care include appropriate history taking, efficacious treatments, and more clinicians specializing in cough. Pharmacists require education on the background of CC and current and future therapies to improve disease competency, clinical decision making, and interventions to enhance the QOL by treating CC. Improved decision making will allow pharmacists to educate people with CC and provide resources to enhance their cough-related QOL.
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To estimate the cost savings associated with a pedometer-based, web-mediated physical activity intervention in a cohort of US veterans with chronic obstructive pulmonary disease (COPD). ⋯ A pedometer-based, web-mediated physical activity intervention yielded substantial cost savings. Increased implementation of the intervention could markedly reduce the economic burden of COPD for payers and patients.
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This study investigates a sample of the pricing data released by hospitals under the price transparency law effective January 2021 to better understand the prices paid by health insurance exchange (HIX) plans relative to commercial group and Medicare Advantage plans. ⋯ Allowed amounts for HIX plans were generally lower than commercial group rates and higher than Medicare Advantage rates. Better information on HIX pricing is needed as the federal government and states consider additional ways to expand health care coverage, such as public options or expanded Medicaid or Medicare eligibility.
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The No Surprises Act took effect in 2022 and prevents patients from receiving unexpected emergency department (ED) out-of-network physician bills from in-network hospitals and restricts out-of-network co-payments to in-network co-payment levels. By studying similar state bans, we examine whether the large reduction in out-of-pocket payments under bans will have an unintended consequence of an increase in ED visits and spending. ⋯ We predict that the federal ban will result in $5.1 billion in savings but 3.5 million more ED visits at $4.2 billion in extra spending per year, largely negating expected savings. Health plans must be prepared to manage this spike in ED visits as the No Surprises Act takes effect.