American Journal of Managed Care最新文献

{"title":"Should I Stay, or Should I Go? Provider Considerations for Leaving Medicaid Managed Care Organizations.","authors":"Monisa Aijaz, Christopher M Shea, Valerie A Lewis, Paula H Song","doi":"10.37765/ajmc.2026.90005","DOIUrl":"https://doi.org/10.37765/ajmc.2026.90005","url":null,"abstract":"<p><strong>Objective: </strong>As states transition from fee-for-service to Medicaid managed care, provider participation is critical for continuity of care. This study examines the factors influencing provider decisions to exit or consider exiting Medicaid managed care organizations (MCOs) following North Carolina's transition to managed care, implemented via a federal Section 1115 demonstration waiver.</p><p><strong>Study design: </strong>We conducted semistructured interviews with 41 individuals representing 26 provider organizations between March and July 2022 and with 47 individuals from 36 provider organizations between March and May 2023.</p><p><strong>Methods: </strong>Our sample included health systems leaders, providers, and administrators from health system-affiliated practices, independent practices, federally qualified health centers, and local health departments. We coded and analyzed data using a thematic analysis approach.</p><p><strong>Results: </strong>Of the 62 participating provider organizations, 34 considered staying with the same number of MCOs, 12 considered reducing the number of contracts, and 2 considered contracting with an additional MCO; others were undecided about their contracting decisions. Three primary themes emerged as drivers of provider exits from MCOs: (1) challenges in the contracting process, (2) increased administrative burden due to operational complexity, and (3) tension between sustaining access to care and maintaining organizational viability. Although many providers initially contracted with all MCOs, persistent operational inefficiencies led some to reduce or reconsider participation.</p><p><strong>Conclusions: </strong>The complexity of managing multiple MCOs is a key factor in provider decisions to exit managed care networks. Policy reforms to standardize operational processes, improve transparency in contracting, and align administrative demands with reimbursement structures are critical to sustaining provider participation and ensuring patient access to care.</p>","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"32 9","pages":"501-507"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a Schizophrenia Pay-for-Performance Program on Health Care Resource Utilization.","authors":"Ning Lu, Valeska N Laksono, Jui-Cheng Chien, Mei-Chih M Tseng, Li-Nien Chien, Kuo-Cherh Huang","doi":"10.37765/ajmc.2026.90011","DOIUrl":"https://doi.org/10.37765/ajmc.2026.90011","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to assess the impacts of a pay-for-performance (P4P) program on health care resource utilization for patients with schizophrenia in Taiwan.</p><p><strong>Study design: </strong>This study employed a difference-in-differences (DID) approach to compare outcome measures between the exposed (P4P program enrollees) and unexposed cohorts across 2 time points (pre and post intervention). Patients were selected from Taiwan's National Health Insurance Research Database between 2009 and 2017, then divided into the exposed and the unexposed cohorts using the double propensity score adjustment technique with a ratio of 1 patient in the exposed cohort to 4 patients in the unexposed cohort, based on the matching criteria of age, sex, and the index date.</p><p><strong>Methods: </strong>Generalized estimating equation with a Poisson distribution and a negative binomial distribution, along with the DID technique, was utilized to estimate the effects of the P4P program on health care resource utilization among enrollees.</p><p><strong>Results: </strong>Patients in the exposed cohort were less likely to have outpatient visits than their counterparts, indicating a reduced demand for outpatient health care (incidence rate ratio [IRR], 0.8357; P  < .0001). However, the P4P program was not effective in reducing emergency department visits (IRR, 1.0234; P  = .6687), hospital admissions (IRR, 0.9146; P  = .3728), or lengths of hospital stay (IRR, 1.1253; P  = .2128).</p><p><strong>Conclusions: </strong>The study demonstrated that the P4P program had mixed effects on health care resource utilization for patients with schizophrenia, particularly regarding the program's effectiveness in reducing reliance on inpatient and emergency services, which was not significant.</p>","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"32 9","pages":"e325-e333"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital Floor Hallway Boarding: A Systematic Review of Outcomes.","authors":"Raya Tcheroyan, Karl Akiki, Krystal Hunter, Samer Badr, Jean-Sebastien Rachoin","doi":"10.37765/ajmc.2026.90013","DOIUrl":"10.37765/ajmc.2026.90013","url":null,"abstract":"<p><strong>Objectives: </strong>The prolonged boarding of admitted patients in the emergency department (ED) increases crowding, a significant challenge for hospitals. Some hospitals have implemented hallway boarding by placing patients in inpatient hallways when standard rooms are unavailable. However, the impact of hallway boarding on patient preferences, clinical outcomes, and patient safety remains uncertain.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of studies comparing boarding patients in an inpatient hallway with those in the ED or a standard inpatient room, examining patient preferences, length of stay (LOS), mortality, or safety outcomes. We used predefined criteria to assess study quality and calculated pooled estimates of patient preference using random-effects models.</p><p><strong>Results: </strong>Eleven studies were included, primarily conducted in the US, with designs ranging from retrospective analyses to surveys of patients, nurses, and physicians. Patient preference was the most studied outcome. Meta-analysis demonstrated that 61% of patients preferred inpatient hallway boarding over ED hallway boarding (95% CI, 50%-71%; P  < .001), although heterogeneity was high ( I² = 87.4%). Fewer studies reported on clinical outcomes. Inpatient hallway boarding was associated with significantly reduced ED LOS in 2 studies (9.3 vs 13.8 hours; 6 vs 8 hours) and hospital LOS in 1. Mortality, as studied in 3 papers, remained unchanged or decreased significantly. Safety outcomes were mixed.</p><p><strong>Conclusion: </strong>Inpatient hallway boarding can improve ED throughput, and most studies show patients prefer it to ED hallway boarding. No study has shown increased mortality, but current research is insufficient to draw clear conclusions about quality and safety.</p>","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"32 9","pages":"e343-e348"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Signs of Success for Missouri's New Notification of Pregnancy.","authors":"Abigail R Barker, Nadim Kanafani, Kelley M Peters, Rashmi Srivastava","doi":"10.37765/ajmc.2026.90014","DOIUrl":"https://doi.org/10.37765/ajmc.2026.90014","url":null,"abstract":"<p><strong>Objectives: </strong>This article describes changes in contact rates, care management (CM) engagement rates, and timeliness of notification after implementation of a new notification of pregnancy (NOP) process by MO HealthNet (Missouri Medicaid) and its 3 managed care organizations (MCOs).</p><p><strong>Study design: </strong>This is an observational study, reporting on all data collected by MO HealthNet during the pilot phase and since implementation of the new statewide NOP process, which includes an assessment of clinical and social risks submitted to MCOs by health care providers.</p><p><strong>Methods: </strong>Descriptive methods are employed to report average contact rates and average care management engagement rates, compared with the MCOs' prior averages. Box-and-whisker plots depict data on gestational weeks of pregnancy over time since the start of the project.</p><p><strong>Results: </strong>Upon statewide implementation, MCOs are successfully contacting 52.8% of all members, compared with an average of 29.3% before the new NOP. Of those contacted, MCOs are engaging 39.7%, compared with 17.0%. Moreover, the median gestational age at NOP submission has declined from 13 to 12 weeks. As of the end of June 2025, 75% of women receive NOP screening by 17 weeks' gestation, representing a consistent improvement since statewide implementation.</p><p><strong>Conclusions: </strong>Implementing a comprehensive, statewide NOP process, reimbursing health care providers for their time, and adding new outreach and provider communication requirements to the Medicaid MCOs may assist state Medicaid programs in addressing their maternal/infant health concerns.</p>","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"32 Spec. No. 9","pages":"eSP538-eSP543"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Patient Out-of-Pocket Medical Costs and Medication Adherence.","authors":"Megha A Parikh, Irene Nsiah, Sujith Ramachandran, Patrick J Campbell, Taruja Karmakar, Heather Black, John P Bentley","doi":"10.37765/ajmc.2026.90006","DOIUrl":"https://doi.org/10.37765/ajmc.2026.90006","url":null,"abstract":"<p><strong>Objectives: </strong>Interventions to reduce cost-related medication nonadherence have focused on reducing out-of-pocket (OOP) prescription drug costs. However, little is known about the impact of OOP medical costs on adherence. This study examines the relationship between patient all-cause OOP medical costs and medication adherence.</p><p><strong>Study design: </strong>A retrospective study was conducted using July 2017 to December 2018 Medicare Advantage data from the Optum Clinformatics Data Mart deidentified database. Inclusion criteria were adapted from the specifications of 3 medication adherence measures used in the Medicare Part D Star Ratings program: diabetes, renin-angiotensin system antagonists (RASAs), and statins.</p><p><strong>Methods: </strong>Multivariable logistic regression models were used to assess the relationship between OOP medical costs and medication adherence across 4 mutually exclusive cohorts-diabetes only, RASA only, statins only, and diabetes-RASA-statins-after adjusting for covariates.</p><p><strong>Results: </strong>A total of 47,091, 443,831, 510,394, and 284,137 individuals were included in the diabetes-only, RASA-only, statins-only, and diabetes-RASA-statins cohorts, respectively. OOP medical costs were associated with a significant decrease in medication adherence across all cohorts. A $1000 increase in patient all-cause OOP medical costs reduced the odds of adherence by 7.3% (OR, 0.927; 95% CI, 0.919-0.935; P  < .001) for statins, 7.4% (OR, 0.926; 95% CI, 0.903-0.949; P  < .001) for diabetes medications, and 11.6% (OR, 0.884; 95% CI, 0.876-0.892; P  < .001) for RASAs. The negative impact of OOP medical costs on adherence was greatest in the diabetes-RASA-statins cohort.</p><p><strong>Conclusions: </strong>Interventions aimed at improving medication adherence should focus on patient OOP prescription drug costs but should also consider the potential impact on adherence of total patient OOP costs incurred for all medical services.</p>","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"32 9","pages":"510-514"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Right Care Initiative: Promoting Accountable Care to Prevent Cardiovascular Death.","authors":"Hector P Rodriguez, Hattie R Hanley, Stephen M Shortell","doi":"10.37765/ajmc.2026.90015","DOIUrl":"https://doi.org/10.37765/ajmc.2026.90015","url":null,"abstract":"<p><strong>Objective: </strong>We describe the rationale for and implementation of the Right Care Initiative and its University of Best Practices (UBP), a model designed to close the implementation gap between clinical evidence and the real-world management of cardiovascular risk factors. The model aims to move beyond institutional silos toward an accountable care model that emphasizes interorganizational partnerships and the systematic sharing of best practices to eliminate preventable mortality.</p><p><strong>Methods: </strong>We summarize lessons from a 17-year learning collaborative involving clinicians, pharmacists, health plans, and public health officials. The collaborative focuses on sharing best practices, peer accountability, and the dissemination of team-based care. The article synthesizes evidence from regional pilot projects, performance variation, and federal policy shifts to support a transition to precision prevention.</p><p><strong>Results: </strong>Effective strategies identified include integrating clinical pharmacists into primary care to manage complex biometrics and utilizing coronary artery calcium imaging for early disease staging. Collaborative learning models address clinical inertia by identifying drug therapy problems and scaling proven interventions, including support for healthy nutrition, weight reduction, and physical activity, across health systems. Aligning value-based payment models with measurable reductions in cardiovascular disease risk holds promise to improve population health.</p><p><strong>Conclusion: </strong>Making progress toward 0 preventable cardiovascular deaths requires developing organizational infrastructure rather than just generating new science. By fostering radical collaboration and adopting advanced diagnostic and team-based tools, health care leaders can ensure that lifesaving evidence reaches patients effectively.</p>","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"32 Spec. No. 9","pages":"eSP544-eSP547"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions About CGMs Among Primary Care Physicians and Endocrinologists.","authors":"Consuela Dennis, Eugene Wright, Stephanie Kohn, James R Gavin Iii, Christopher G Parkin, Steven V Edelman","doi":"10.37765/ajmc.2026.90010","DOIUrl":"https://doi.org/10.37765/ajmc.2026.90010","url":null,"abstract":"<p><strong>Objectives: </strong>To identify clinicians' current practice behaviors, attitudes, and obstacles shaping continuous glucose monitoring (CGM) use.</p><p><strong>Study design: </strong>This structured survey asked clinicians about their practice environments, their views on the value of CGM and the importance of comprehensive training and education, their preferred prescribing channels for CGM, and details specific to each practice type.</p><p><strong>Methods: </strong>Survey participants were selected by PureSpectrum, which used the PureScore system to evaluate participant suitability, collect data, and analyze results. The data show the percentage of respondents in each clinician group who answered each question.</p><p><strong>Results: </strong>Responses from 101 primary care physicians (PCPs) and 106 endocrinologists were obtained for analysis. Levels of familiarity with the newest CGM technologies were consistent among PCPs and endocrinologists. A large percentage of both PCPs and endocrinologists indicated that concerns about patients' ability to afford CGM were a main reason for prescribing traditional blood glucose monitoring. The majority of PCPs (69%) and endocrinologists (73%) who prescribe CGM prefer the durable medical equipment (DME) channel. Most PCPs (92%) and endocrinologists (91%) indicated they would likely prescribe CGM through the DME channel more often if those suppliers offered disease education and coaching. A large percentage of endocrinologists (76%) and a smaller percentage of PCPs (45%) reported feeling pressured by health insurers to prescribe through the pharmacy channel.</p><p><strong>Conclusion: </strong>Clinician prescribing behaviors continue to be shaped by systemic barriers, including insurance pressures and concerns about patient ability/readiness to use CGM technology.</p>","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"32 9","pages":"e316-e324"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The One Big Beautiful Bill Act and Cancer Care: What Oncology Leaders Need to Know and Do Now.","authors":"Arunkumar Krishnan","doi":"10.37765.ajmc.2026.90003","DOIUrl":"https://doi.org/10.37765.ajmc.2026.90003","url":null,"abstract":"<p><p>The One Big Beautiful Bill Act (OBBBA), enacted on July 4, 2025, represents the most substantial restructuring of Medicaid financing since the Balanced Budget Act of 1997. Key provisions include semiannual eligibility redeterminations for expansion adults,implementation of work requirements no later than January 1, 2027, a $35 per-service cost-sharing obligation for adults with incomes between 100% and 138% of the federal poverty level starting in October 2028, and a freeze on provider tax mechanisms. The Congressional Budget Office projects that these measures will result in coverage loss for 11.8 million individuals by 2034. The Congressional Budget Office estimates that the law will increase the number of uninsured people by 10 million in 2034, relative to estimates made before enactment. These policy changes have direct operational consequences for oncology programs. Multicycle cancer therapy necessitates uninterrupted coverage and continuous prior authorization; any lapse may lead to delayed chemotherapy, abandoned treatment protocols, and poorer clinical outcomes. While prior analyses have addressed the epidemiologic and fiscal dimensions of OBBBA, an operational framework for oncology program administrators and managed care decision makers remains absent. This commentary addresses the gap by presenting a framework grounded in peer-reviewed evidence regarding Medicaid work requirement effects, the impact of cost sharing on cancer treatment adherence, and prior authorization burdens in oncology. The proposed framework encompasses 3 operational domains: proactive financial counseling and eligibility infrastructure, payer mix modeling and scenario planning, and prior authorization workflow optimization. Oncology programs that establish these infrastructures during fiscal year 2026 will be better positioned to manage the coverage transition, whereas those that delay may encounter simultaneous challenges related to patient access and financial stability.</p>","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"32 9","pages":"484-486"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potentially Inappropriate Medication Use Following Hospital Discharge Among Medicare Beneficiaries.","authors":"Eli Wei Raver, Jeah Jung, Macarius M Donneyong, Tanya R Gure, Jeffrey Wing, Wendy Y Xu","doi":"10.37765/ajmc.2026.89996","DOIUrl":"10.37765/ajmc.2026.89996","url":null,"abstract":"<p><strong>Objectives: </strong>Medicare beneficiaries 65 years and older are susceptible to receiving potentially inappropriate medications (PIMs), for which the risks outweigh the benefits. Unlike stand-alone Part D prescription drug plans serving traditional Medicare (TM) beneficiaries, Medicare Advantage (MA) plans have a financial incentive to improve transitional care following hospitalization and reduce PIM use in order to avoid costly adverse drug events. This study examined how changes in PIM use following hospitalization differed between TM and MA.</p><p><strong>Study design: </strong>This observational study analyzed nationwide Medicare Part D Event files, TM fee-for-service claims, and MA encounter data from 2016 to 2019. It included 675,776 hospitalization episodes for Medicare beneficiaries 65 years and older with Part D prescription drug coverage.</p><p><strong>Methods: </strong>We conducted a difference-in-differences analysis of PIM use before and after hospitalization between TM and MA. PIM use was measured as any Part D dispensing event for a high-risk medication during the 180 days before and after hospitalization.</p><p><strong>Results: </strong>The prevalence of PIM use in TM was 23.90% preadmission and 23.29% post discharge and in MA was 21.82% preadmission and 21.47% post discharge. After adjusting for patient factors, the decrease in PIM use following hospitalization was 0.25 percentage points (95% CI, 0.02-0.49) less in MA than in TM.</p><p><strong>Conclusions: </strong>Although MA plans are likely to have stronger financial incentives than TM to reduce PIM use, we found that MA and TM beneficiaries experienced similar changes in PIM use following hospitalization.</p>","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"32 8","pages":"e273-e279"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations for the Use of Tebentafusp, a BiTE Approved for Rare, High-Risk Uveal Melanoma.","authors":"Yonatan S Resnick","doi":"10.37765/ajmc.2026.90037","DOIUrl":"https://doi.org/10.37765/ajmc.2026.90037","url":null,"abstract":"","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"32 Spec. No. 9","pages":"SP451-SP453"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}