The American journal of managed care
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Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by hepatic steatosis that is confirmed by imaging or histology in the setting of at least 1 metabolic risk factor in the absence of significant alcohol consumption. Nonalcoholic steatohepatitis, or NASH, was recently renamed metabolic dysfunction-associated steatohepatitis (MASH); it represents the progressive form of MASLD. MASH is defined by hepatic steatosis, lobular inflammation, and ballooning degeneration (hepatocellular injury) in a characteristic histologic pattern. ⋯ Multiple MASH treatment options are in various stages of development. The THR-β agonist resmetirom, approved by FDA in March 2024, offers a liver-directed treatment for those patients living with moderate to severe fibrosis without cirrhosis. Considering the progressive nature of the disease and the availability of a treatment that can be initiated early to halt MASH progression, patients who have risk factors for MASH should urgently be encouraged to visit their health care providers for MASH screening.
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Randomized Controlled Trial
Proactive care management of AI-identified at-risk patients decreases preventable admissions.
We assessed whether proactive care management for artificial intelligence (AI)-identified at-risk patients reduced preventable emergency department (ED) visits and hospital admissions (HAs). ⋯ A care management intervention targeting AI-identified at-risk patients was followed by a onetime, significant, sizable reduction in preventable HA rates. Further exploration is needed to assess the potential of integrating AI and care management in preventing acute hospital encounters.
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To compare rates and analyze health facility determinants of emergency department visits and hospitalizations for ambulatory care-sensitive conditions (ACSCs) among Medicaid patients by geographical location. ⋯ Our evaluation revealed more than 13-fold variation in acute care utilization for ACSCs between Medicaid counties within the same state. Proximity to urgent care facilities and density of rural health clinics were major explanatory variables for these variations, underscoring the importance of local health infrastructure in reducing acute care utilization for ACSCs.
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This study was designed to assess physician experiences with utilization management and burnout and investigate whether they are linked. ⋯ These findings indicate that utilization management has a detrimental impact on physicians and patient care and contributes to physician burnout.
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This study describes the use of data-based feedback, such as human papillomavirus (HPV) vaccination rates, to advance HPV vaccination uptake in pediatric and family medicine clinics. ⋯ Clinical staff seldom receive feedback about HPV vaccination in primary care.