The American journal of managed care
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The use of electronic health record (EHR) systems by US clinicians is nearly ubiquitous. One motivation for EHR implementation is the ability to increase provider efficiency and improve patient-centered outcomes. There are no data examining how EHR design aligns with the ordering of high- and low-value clinical services. ⋯ In EHR systems used nationwide, no association existed between the clinical value of a service and the ease of ordering. This disconnect suggests that EHR redesign can significantly improve clinician workflow to facilitate the use of more high-value care and fewer low-value services.
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To inform state Medicaid programs and managed care organizations, as well as to build their capacity to serve enrollees with complex needs related to serious mental illness (SMI). ⋯ Individuals with chronic and complex conditions can be challenging for managed care organizations to support, especially Medicaid enrollees with SMI, who experience high rates of comorbid physical health conditions and complex healthcare needs. To the extent that managed care organizations can help this population navigate their coverage and use more of the available benefits, barriers to care and unmet needs can be reduced or eliminated and outcomes subsequently improved.
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Comparative Study
Changes in ambulatory utilization after switching from Medicaid fee-for-service to managed care.
To observe any change in ambulatory care utilization after switching from Medicaid fee-for-service (FFS) to Medicaid managed care (MC). ⋯ Switching from Medicaid FFS to Medicaid MC was associated with a decrease in ambulatory utilization, especially for the sickest patients.