The American journal of managed care
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To evaluate the association and concordance of the new 8-item self-report Morisky Medication Adherence Scale (MMAS) with pharmacy fill data in a sample of community-dwelling seniors with hypertension. ⋯ The MMAS is significantly associated with antihypertensive drug pharmacy refill adherence. Although further validation of the MMAS is needed, it may be useful in identifying low medication adherers in clinical settings.
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To examine the reliability of quality measures to assess physician performance, which are increasingly used as the basis for quality improvement efforts, contracting decisions, and financial incentives, despite concerns about the methodological challenges. ⋯ In typical health plan administrative data, most physicians do not have adequate numbers of quality events to support reliable quality measurement. The reliability of quality measures should be taken into account when quality information is used for public reporting and accountability. Efforts to improve data available for physician profiling are also needed.
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To examine whether initiation of a biologic agent to treat 2 autoimmune disorders -- rheumatoid arthritis (RA) and multiple sclerosis (MS) -- affects use of other medical services. ⋯ Given the high cost of many specialty drugs, health plans may rightly focus on making sure only patients who will most benefit receive them. But once such patients are identified, it makes little sense to limit coverage.
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To review literature on the impact of bipolar disorder on the workplace, with respect to costs to employers, workplace productivity and functioning, and any employer-initiated programs implemented with the aim of improving work attendance and performance. ⋯ Bipolar disorder among the working population can have a significant, negative effect on work relationships, attendance, and functioning, which can lead to substantial costs to US employers arising from lost productivity. There is a need for workplace initiatives to address the health and cost consequences of bipolar disorder within an employed population.
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To compare the generosity and consistency of 10 states' Medicaid preferred drug lists (PDLs) in high-volume therapeutic classes. ⋯ For most drugs, Medicaid PDLs are not implemented consistently across states, suggesting that states do not rely on common clinical evidence to make value-based coverage decisions. Greater involvement by the federal government in designing or regulating monopolistic Medicare Part D PDLs may result in similar inconsistencies.