American Journal of Managed Care最新文献_第3页

Care coordination engagement patterns in long-term patients. 长期病人的护理协调参与模式。

IF 2.5 4区医学

American Journal of Managed Care Pub Date : 2025-04-01 DOI: 10.37765/ajmc.2025.89718

Nicolas M Oreskovic, Zachary A Allon, Ann E Erwin

{"title":"Care coordination engagement patterns in long-term patients.","authors":"Nicolas M Oreskovic, Zachary A Allon, Ann E Erwin","doi":"10.37765/ajmc.2025.89718","DOIUrl":"https://doi.org/10.37765/ajmc.2025.89718","url":null,"abstract":"Objective: Health care networks are increasingly turning to programs that provide office-based care coordination to high-cost, high-need patients to control preventable health care costs. Although care coordination programs have been shown to result in shorter-term cost benefits, little is known about patients who remain in such programs beyond 2 years. This study sought to assess the amount of care coordination engagement over time in patients enrolled for more than 2 years in an office-based care coordination program.Study design: Cohort study with 9 years of follow-up data.Methods: The study population was adult patients enrolled for 2 or more years as of November 2023 in an office-based care coordination program at a major academic medical center in Boston, Massachusetts. The association between patient length of enrollment in an outpatient care coordination program and amount of care coordination engagement was assessed using linear regression, with differences between cohorts compared by t test and analysis of variance. Engagement patterns in 5 sequential study cohorts based on date of enrollment were compared.Results: Among all 2258 patients enrolled, care coordination engagement increased linearly over time, with a mean increase of 0.2 care coordination encounters per patient per year. Similar increasing engagement patterns over time were observed across all study cohorts.Conclusions: Length of time enrolled in an office-based care coordination program predicted care coordination engagement, with care coordination services increasing the longer patients remained in the program.","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"31 4","pages":"166-171"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054910","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}

引用次数: 0

Technology, partnerships, data, and culture are keys to bringing precision medicine to community oncology. 技术、伙伴关系、数据和文化是将精准医学引入社区肿瘤学的关键。

IF 2.5 4区医学

American Journal of Managed Care Pub Date : 2025-04-01 DOI: 10.37765/ajmc.2025.89727

Mary Caffrey

引用次数: 0

AI in health care: closing the revenue cycle gap. 医疗保健中的人工智能：缩小收入周期差距。

IF 2.5 4区医学

American Journal of Managed Care Pub Date : 2025-04-01 DOI: 10.37765/ajmc.2025.89717

Erin Weber, Kristine Burnaska, Robert Bowman, Samantha Holvey

引用次数: 0

Impact of hospital-physician integration on Medicare patient mix. 医院-医生整合对医疗保险患者组合的影响。

IF 2.5 4区医学

American Journal of Managed Care Pub Date : 2025-04-01 DOI: 10.37765/ajmc.2025.89724

Brady Post, Farbod Alinezhad, Gary J Young

{"title":"Impact of hospital-physician integration on Medicare patient mix.","authors":"Brady Post, Farbod Alinezhad, Gary J Young","doi":"10.37765/ajmc.2025.89724","DOIUrl":"https://doi.org/10.37765/ajmc.2025.89724","url":null,"abstract":"Objectives: Hospital employment of physicians, often called hospital-physician vertical integration, has become widespread in health care delivery, but whether hospital employment tilts the case mix of physicians toward higher-complexity patients remains unknown.Study design: Cross-sectional and difference-in-differences analysis of 2014-2019 Medicare Standard Analytic Files.Methods: We compared pre- and postemployment patient panels of primary care physicians who did and did not become hospital employees, analyzing changes in the prevalence of chronic conditions. We measured arthritis, depression, diabetes, hypertension, and ischemic heart disease. We also evaluated whether patients who were dropped from physician panels found alternative sources of primary care.Results: Hospital-employed physicians treated patients of similar or better health; for instance, 54% of integrated physicians' patients had 2 or more chronic conditions compared with 56% among independent physicians (P < .001). After becoming hospital employees, physicians treated approximately 10% fewer Medicare patients (-9.5%; 95% CI, -11.3% to -7.7%). Within physician panels, the prevalence of patients with 2 or more chronic conditions did not significantly change after employment relative to independent physicians (-1.1%; 95% CI, -2.3% to 0.2%). Approximately 37% of patients were dropped from physician panels after employment; these patients were less likely to find alternative primary care compared with those dropped from independent physician panels (P < .001).Conclusions: Hospital employment of physicians resulted in neither a higher number nor a higher proportion of complex patients treated by integrated physicians, at least among traditional Medicare patients.","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"31 4","pages":"e95-e101"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044196","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}

引用次数: 0

Demographic disparities in video visit telemetry: understanding telemedicine utilization. 视频访问遥测的人口差异：了解远程医疗的利用。

IF 2.5 4区医学

American Journal of Managed Care Pub Date : 2025-03-01 DOI: 10.37765/ajmc.2025.89699

Daniel Stein, Mark L Moubarek, Jeffrey Fine, Jeffery Wajda, Mark Avdalovic

{"title":"Demographic disparities in video visit telemetry: understanding telemedicine utilization.","authors":"Daniel Stein, Mark L Moubarek, Jeffrey Fine, Jeffery Wajda, Mark Avdalovic","doi":"10.37765/ajmc.2025.89699","DOIUrl":"10.37765/ajmc.2025.89699","url":null,"abstract":"Objectives: To investigate demographic disparities in failed episodes of telemedicine utilization. The primary hypothesis was that certain demographic groups, including older adults and specific racial or ethnic groups, would experience disparate amounts of failed video visits.Study design: A retrospective review was conducted using electronic health record-integrated scheduled telehealth video visit telemetry data gathered for all video visits at a California academic health center from September 1, 2020, to November 30, 2020. For each visit, we collected demographics including age, sex, ethnicity, primary language, and race.Methods: Outcomes were categorized as successful or failed based on review of telemetry data. Successful visits were defined as simultaneous connections and completion of video visit, whereas failed visits were defined as provider-reported failure or lack of simultaneous connections for the telemedicine visit. Binomial generalized logistic regression using a generalized estimating equation approach was used to assess the impact of demographic factors on video visit success. Of 47,065 scheduled telemedicine video visits, telemetry data were available for 30,996; the 16,069 visits excluded from the study were due to no-shows, cancellations, or a nonintegrated solution being utilized.Results: Of 30,996 visits included in the study, 27,273 were successfully completed. Analysis of the 3723 failed visits revealed that older adults and African American/Black patients were more likely to experience failed video visits, with ORs of 2.02 and 1.56, respectively.Conclusions: This study highlights the significant demographic disparities in failed video visit occurrence caused by technical failure as demonstrated by telemetry data. These findings highlight the need for targeted interventions and opportunity for improved outcomes.","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"31 3","pages":"e69-e73"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576001","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}

引用次数: 0

The health information technology special issue: evolving tech, fundamental methods. 卫生信息技术特刊：技术演进、基本方法。

IF 2.5 4区医学

American Journal of Managed Care Pub Date : 2025-03-01 DOI: 10.37765/ajmc.2025.89694

Courtney R Lyles

引用次数: 0

Health impacts of health system implementation of a food-as-medicine strategy. 卫生系统实施食物即药物战略对健康的影响。

IF 2.5 4区医学

American Journal of Managed Care Pub Date : 2025-03-01 DOI: 10.37765/ajmc.2025.89706

Sarah D Ronis, Holly Hartman, Ian J Neeland, Anne Leach, Celina Cunanan

{"title":"Health impacts of health system implementation of a food-as-medicine strategy.","authors":"Sarah D Ronis, Holly Hartman, Ian J Neeland, Anne Leach, Celina Cunanan","doi":"10.37765/ajmc.2025.89706","DOIUrl":"10.37765/ajmc.2025.89706","url":null,"abstract":"Objectives: To describe a regional health system's experience with medically tailored groceries (MTG), focusing on program reach and effectiveness as determined by observed within-person changes in cardiometabolic measures.Study design: Case study including individuals aged 18 to 79 years referred by an ambulatory health care provider to a single regional health system's MTG program from April 2020 through September 2023.Methods: Demographics, clinical characteristics, and cardiometabolic measures (blood pressure [BP], weight, body mass index [BMI], and hemoglobin A1c [HbA1c]) were abstracted from electronic health records. Descriptive and bivariate analyses evaluated differences in demographics and comorbid conditions among those who ever vs never used the Food for Life Market. Weighted linear mixed-effect models evaluated the expected change in outcomes from baseline to recent measure, accounting for demographics, time between measures, and attributed market location.Results: A total of 2259 adults received referrals to the MTG program (median, 1 referral; range, 1-7; 3184 total referrals). Of those referred, 1397 (61.8%) ever attended; MTG users were significantly older than nonusers (median age, 52.9 vs 38.3 years; P < .001). MTG program attendance was associated with favorable changes in market attendees vs nonusers in diastolic BP (-0.54 vs -0.51 mm Hg; P = .04) and BMI (0.20 vs 0.23; P = .02) after 3 years from baseline, after accounting for confounders. No significant differences were observed in systolic BP, HbA1c, or weight.Conclusions: An unincentivized MTG intervention demonstrated modest impacts on key cardiometabolic measures. Future efforts to colocate MTG sites with clinical settings may enhance program uptake and impact on cardiometabolic measures.","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"31 Spec. No. 3","pages":"SP127-SP135"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626759","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}

引用次数: 0

The "new" new normal: changes in telemedicine utilization since COVID-19. 新 "的新常态：自 COVID-19 以来远程医疗利用率的变化。

IF 2.5 4区医学

American Journal of Managed Care Pub Date : 2025-03-01 DOI: 10.37765/ajmc.2025.89700

Soumik Mandal, Batia M Wiesenfeld, Devin M Mann, Oded Nov

{"title":"The \"new\" new normal: changes in telemedicine utilization since COVID-19.","authors":"Soumik Mandal, Batia M Wiesenfeld, Devin M Mann, Oded Nov","doi":"10.37765/ajmc.2025.89700","DOIUrl":"10.37765/ajmc.2025.89700","url":null,"abstract":"Objective: To evaluate trends in telemedicine utilization overall and across clinical specialties, providing insights into its evolving role in health care delivery.Study design: This retrospective cross-sectional study analyzed 1.9 million telemedicine video visits from a large academic health care system in New York City between 2020 and 2023. The data, collected from the health care system's electronic health records, included telemedicine encounters across more than 500 ambulatory locations.Methods: We used descriptive statistics to outline telemedicine usage trends and compared telemedicine utilization rates and evaluation and management characteristics across clinical specialties.Results: Telemedicine utilization peaked during the COVID-19 pandemic, then declined and stabilized. Despite an overall decline, 2 non-primary care specialties (behavioral health and psychiatry) experienced continued growth in telemedicine visits. Primary care and urgent care visits were mainly characterized by low-complexity visits, whereas non-primary care specialties witnessed a rise in moderate- and high-complexity visits, with the number of moderate-level visits surpassing those of low complexity.Conclusions: The findings highlight a dynamic shift in telemedicine utilization, with non-primary care settings witnessing an increase in the complexity of cases. To address future demands from increasingly complex medical cases managed through telemedicine in non-primary care, appropriate resource allocation is essential.","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"31 3","pages":"e74-e78"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575957","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}

引用次数: 0

Managed care reflections: a Q&A with Julia Adler-Milstein, PhD. 管理式医疗反思：与 Julia Adler-Milstein 博士的问答。

IF 2.5 4区医学

American Journal of Managed Care Pub Date : 2025-03-01 DOI: 10.37765/ajmc.2025.89693

Julia Adler-Milstein, Christina Mattina

引用次数: 0

Reducing readmissions in the safety net through AI and automation. 通过人工智能和自动化减少安全网的重新接纳。

IF 2.5 4区医学

American Journal of Managed Care Pub Date : 2025-03-01 DOI: 10.37765/ajmc.2025.89697

Daniel J Bennett, Jean Feng, Seth Goldman, Avni Kothari, Laura M Gottlieb, Matthew S Durstenfeld, James Marks, Susan Ehrlich, Jonathan Davis, Lucas S Zier

{"title":"Reducing readmissions in the safety net through AI and automation.","authors":"Daniel J Bennett, Jean Feng, Seth Goldman, Avni Kothari, Laura M Gottlieb, Matthew S Durstenfeld, James Marks, Susan Ehrlich, Jonathan Davis, Lucas S Zier","doi":"10.37765/ajmc.2025.89697","DOIUrl":"10.37765/ajmc.2025.89697","url":null,"abstract":"Objectives: To implement a technology-based, systemwide readmission reduction initiative in a safety-net health system and evaluate clinical, care equity, and financial outcomes.Study design: Retrospective interrupted time series analysis between October 2015 and January 2023.Methods: The readmission reduction initiative standardized inpatient care for patients through a novel, electronic health record-integrated, digitally automated point-of-care decision-support tool. A predictive artificial intelligence algorithm was utilized to identify patients at the highest risk of readmission in both the inpatient and outpatient settings, allowing a population health team to perform proactive outpatient management in medical and social domains to avoid readmission.Results: Readmission rates declined from 27.9% in the preimplementation period to 23.9% in the postimplementation period ( P < .004) by the end of 2023. A significant gap in readmission rates between Black/African American patients and the general population was eliminated over the course of the evaluation period. Survival analysis demonstrated a reduction in all-cause mortality in the postimplementation period (HR, 0.82; 95% CI, 0.68-0.99; P = .037). Improvement in readmission rates allowed the health system to retain $7.2 million of at-risk pay-for-performance funding.Conclusions: This technology-based readmission reduction initiative demonstrated efficacy in reducing readmission rates, closing equity gaps, improving survival, and leading to a positive financial impact in a safety-net health system. This approach could be an effective model of technology-based, value-based care for other resource-limited health systems to meet pay-for-performance metrics and retain at-risk funding while improving clinical and equity outcomes.","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"31 3","pages":"142-148"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575956","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}

引用次数: 0