The American journal of managed care
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To estimate payments for the treatment of COVID-19 compared with that of influenza or viral pneumonia (IP), from the perspective of the US payer. ⋯ Payments associated with severe/critical COVID-19 significantly exceeded those associated with IP. For Medicare, IP was more expensive than mild or moderate COVID-19. For commercial payers, IP was less expensive than moderate COVID-19 but more expensive than mild COVID-19.
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To examine guideline-concordant care (GCC) for ovarian cancer, identify its predictors, and evaluate the associations between GCC and survival, health care expenditures, and utilization. ⋯ Non-GCC was associated with worsened survival, higher health care utilization, and increased expenditures. It is important to highlight that women who received GCC were associated with better survival likely due to favorable prognostic clinical factors.
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Evaluate the clinical utility of a precision-guided dosing test for infliximab (IFX) and its impact on treatment decision-making for inflammatory bowel disease (IBD). ⋯ PredictrPK IFX enables earlier and more precise dose optimization of IFX in patients with IBD, exerting a substantial impact on treatment decisions that may result in improved health outcomes and overall cost savings.
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To describe trends in US health care spending in a large, national, and commercially insured population during the COVID-19 pandemic. ⋯ The COVID-19 pandemic induced a spending shock in 2020, and health care spending did not recover to near baseline until mid-2021, with some emerging evidence of pent-up demand. The observed spending below baseline through the end of 2021 will pose challenges to setting spending benchmarks for alternative payment and shared savings models.
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Commercial health insurers can participate in the rapidly growing Medicare Advantage (MA) market, which may affect network formation and prices in traditional commercial insurance markets. We aim to quantify the prevalence and growth of commercial insurers participating in MA within the same state. ⋯ By 2021, almost all ESI enrollees were covered by insurers who participated in MA in the same state. Future research should investigate how insurer participation in MA affects network formation and prices in commercial markets.