The American journal of managed care
-
To examine associations between accountable care organization (ACO) membership and human papillomavirus (HPV) vaccination and to evaluate variation in HPV vaccination across ACO providers. ⋯ Adolescents receiving care from ACOs were significantly more likely to initiate and complete HPV vaccination than were adolescents receiving care in non-ACO settings. Variation in HPV vaccine uptake attributable to providers within ACOs dwarfed variation attributable to ACOs, indicating that vaccine uptake was more dependent on the provider irrespective of the ACO with which they were affiliated. Efforts to improve HPV vaccination rates may require provider-focused interventions regardless of the overall performance of their health care system or provider organization.
-
Prior authorization is used to ensure providers treat patients with medically accepted treatments. Our objective was to evaluate prior authorization decisions in cancer care by race/ethnicity for commercially insured patients. ⋯ We observed no differences in the prior authorization process for Black and Hispanic patients with cancer and higher rates of prior authorization approvals for Asian patients compared with White patients.
-
This study aims to investigate the relocation of older adults in the US from community living to long-term care facilities (LTCFs). Specifically, it examines the predictive roles of possible and probable dementia and hospital stays in this complex health care transition. ⋯ The study findings emphasize complexity in late-life relocations influenced by dementia and hospital stays. Screening for cognitive function among community-dwelling older adults, particularly those with a history of hospital stays and mobility difficulties, can inform interventions and policies. Implications extend to health care policy, geriatric care, and the imperative for targeted interventions considering demographic variations. Future research should explore additional variables and address limitations to refine our understanding of the relocation process.
-
Observational Study
Cost savings from an mHealth tool for improving medication adherence.
To determine the health care cost savings from the Wellth app, a mobile health intervention that uses financial incentives to increase medication adherence. ⋯ Given the relatively low cost of the Wellth intervention, our findings provide preliminary evidence of cost savings from implementing Wellth among adults with several common chronic conditions.
-
To describe the results of a program developed to manage institutional postacute care (IPAC) (postacute skilled nursing, inpatient rehabilitation facility, and long-term acute care) in a CMS Bundled Payments for Care Improvement (BPCI) project for coronary artery bypass graft (CABG) surgery. ⋯ A strong association exists between a focused patient functional recovery program and IPAC use reduction after CABG surgery. Using a structured approach to clinical analytics and hypothesis testing of redesign efforts when managing postacute care populations removes waste from care delivery.