American Journal of Managed Care最新文献_第7页

Real-world weight loss with injectable semaglutide vs dulaglutide for diabetes. 注射西马鲁肽与杜拉鲁肽治疗糖尿病的实际减肥效果。

IF 2.1 4区医学

American Journal of Managed Care Pub Date : 2026-06-01 DOI: 10.37765/ajmc.2026.89952

Allison Spitery, Alison Lobkovich, Emily Thomas

{"title":"Real-world weight loss with injectable semaglutide vs dulaglutide for diabetes.","authors":"Allison Spitery, Alison Lobkovich, Emily Thomas","doi":"10.37765/ajmc.2026.89952","DOIUrl":"10.37765/ajmc.2026.89952","url":null,"abstract":"Objective: To compare the real-world effects of weekly injectable semaglutide (Ozempic) vs dulaglutide (Trulicity) on weight loss in an urban, predominantly African American patient sample with type 2 diabetes (T2D).Study design: This retrospective cohort study included adult patients with T2D at an academic internal medicine clinic who were initiated on semaglutide or dulaglutide.Methods: The primary outcome was the percentage change in actual body weight (ABW) from baseline at 52 weeks. Secondary outcomes included mean weight loss in kg, weight loss of at least 5% and at least 10% at 52 weeks, percentage change in hemoglobin A1c (HbA1c) at 52 weeks, and HbA1c levels of less than 7% and less than 8% at 52 weeks.Results: The percentage change in ABW from baseline at 52 weeks was greater with semaglutide (n = 60) than with dulaglutide (n = 60) (-6.51% vs -1.14%; P = .001). The absolute change in ABW at 52 weeks was greater with semaglutide than with dulaglutide (-15.98 kg vs -4.93 kg; P = .001). More patients using semaglutide achieved weight loss of at least 5% and at least 10% at 52 weeks than those using dulaglutide (≥ 5%: 51.7% vs 25.0%; P = .003; ≥ 10%: 31.7% vs 8.3%; P = .001). A higher percentage of patients using semaglutide than those using dulaglutide achieved an HbA1c less than 7% and less than 8% at 52 weeks (< 7%: 53.3% vs 38.3%; P = .100; < 8%: 78.3% vs 68.3%; P = .220). The absolute change in HbA1c was greater with semaglutide than dulaglutide (-2.15% vs -1.36%; P = .033).Conclusions: Treatment with semaglutide resulted in a greater reduction in body weight and HbA1c than with dulaglutide in a real-world study of patients with T2D.","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"32 6","pages":"328-333"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310281","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

Employers can now save by comparing health care prices. 雇主现在可以通过比较医疗价格来节省开支。

IF 2.1 4区医学

American Journal of Managed Care Pub Date : 2026-06-01 DOI: 10.37765/ajmc.2026.89929

David Schleifer, Raymond Tsai

引用次数: 0

The effect of Medicaid reimbursement for psychiatrists on the health care burden of serious mental illness. 精神科医生医疗补助对严重精神疾病医疗负担的影响。

IF 2.1 4区医学

American Journal of Managed Care Pub Date : 2026-06-01 DOI: 10.37765/ajmc.2026.89961

Onur Baser, Heidi C Waters, Nehir Yapar, Gabriela Samayoa, Xue Han, Deborah Freedman, Lauren Isenman, Rashmi Patel

{"title":"The effect of Medicaid reimbursement for psychiatrists on the health care burden of serious mental illness.","authors":"Onur Baser, Heidi C Waters, Nehir Yapar, Gabriela Samayoa, Xue Han, Deborah Freedman, Lauren Isenman, Rashmi Patel","doi":"10.37765/ajmc.2026.89961","DOIUrl":"https://doi.org/10.37765/ajmc.2026.89961","url":null,"abstract":"Objective: Health care resource utilization (HCRU) and cost among Medicaid patients with serious mental illness (SMI) were compared in states with high and low reimbursement for psychiatric services.Study design: Retrospective cohort study.Methods: Using 2021-2023 Kythera Labs Medicaid data, the 20 most frequently billed procedures by psychiatrists were identified. We selected states with the top 20% and bottom 20% mean reimbursement. The SMI population had 1 or more medical claims for SMI during the identification period and continuous enrollment for 1 year pre- and post diagnosis. The effect of reimbursement rates on health outcomes was estimated, controlling for patient-level and fixed-state characteristics.Results: The high-reimbursement-rate cohort (n = 99,024) was 5% less likely to have psychiatric-specific inpatient and outpatient visits and 23% less likely to have psychiatric-specific emergency department (ED) visits than the low-reimbursement cohort (n = 154,437). The high-reimbursement cohort was less likely to have inpatient and ED visits and demonstrated 24% lower overall costs and 19% lower psychiatric-specific costs annually.Conclusions: Higher Medicaid reimbursement rates for psychiatric services were associated with reduced HCRU and costs. Although this observed association may not imply causality, it could reflect beneficial behavioral changes (eg, improved provider participation and care continuity) or unintended mechanisms such as increased utilization review that may restrict access.","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"32 6","pages":"e198-e204"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310241","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

Changes in persistence to basal insulin following the Medicare out-of-pocket cost cap. 医疗保险自付费用上限后基础胰岛素持久性的变化。

IF 2.1 4区医学

American Journal of Managed Care Pub Date : 2026-06-01 DOI: 10.37765/ajmc.2026.89963

Razanne Oueini, Ben Shirley, Christie Teigland, Melissa Castora-Binkley, Scott Bilder, Kiran Sunkari, Lynn Pezzullo

{"title":"Changes in persistence to basal insulin following the Medicare out-of-pocket cost cap.","authors":"Razanne Oueini, Ben Shirley, Christie Teigland, Melissa Castora-Binkley, Scott Bilder, Kiran Sunkari, Lynn Pezzullo","doi":"10.37765/ajmc.2026.89963","DOIUrl":"https://doi.org/10.37765/ajmc.2026.89963","url":null,"abstract":"Objective: To evaluate changes in persistence to basal insulin following the implementation of the $35 monthly out-of-pocket cost cap for insulin for Medicare beneficiaries.Study design: We completed a retrospective cohort analysis of a nationally representative Medicare Advantage sample from 2022 to 2023.Methods: We compared precap rates of persistence to basal insulin in 2022 with postcap rates in 2023 using Persistence to Basal Insulin, a health plan performance measure used in Medicare Part D quality programs, among the study population and multiple subgroups.Results: A statistically significant increase (+1.3 percentage points; P < .001) was seen in overall patient persistence to basal insulin in the first year of the implementation of the insulin cost cap. Subgroup analyses showed greater increases in persistence in several subpopulations, including patients aged 45 to 54 and 65 to 74 years, male patients, non-Hispanic Black patients, and patients residing in certain census divisions, especially those with a high prevalence of type 2 diabetes.Conclusions: In addition to providing financial relief to Medicare patients, the implementation of the insulin cost cap was associated with an improvement in patients' treatment persistence to basal insulin therapy, a measure associated with positive health and economic outcomes. These results lend useful insight into future policy evaluations and proposals that seek to improve treatment access and address disparities in appropriate medication use.","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"32 6","pages":"e212-e216"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310072","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

Associations between socioeconomic status, healthy lifestyle, and multimorbidity in the US. 美国社会经济地位、健康生活方式和多病之间的关系

IF 2.1 4区医学

American Journal of Managed Care Pub Date : 2026-06-01 DOI: 10.37765/ajmc.2026.89967

Shifeng Wu

{"title":"Associations between socioeconomic status, healthy lifestyle, and multimorbidity in the US.","authors":"Shifeng Wu","doi":"10.37765/ajmc.2026.89967","DOIUrl":"10.37765/ajmc.2026.89967","url":null,"abstract":"Objective: To investigate the relationships between socioeconomic status (SES) and multimorbidity, which can inform public health strategies.Study design: Cross-sectional study.Methods: Data from participants in the National Health and Nutrition Examination Survey 2007-2018 were analyzed. Weighted multivariate logistic regression assessed associations between multimorbidity, SES, and healthy lifestyles. Subgroup analyses stratified by key covariates evaluated stratified risks. Sensitivity analyses verified result robustness.Results: After adjustment, compared with low-SES individuals, medium-SES individuals showed a significantly increased OR of multimorbidity (1.267; 95% CI, 1.079-1.489), whereas high-SES individuals exhibited a significantly decreased OR (0.723; 95% CI, 0.647-0.807). Healthy lifestyles exerted a protective effect, particularly within the medium-SES subgroup. Middle-aged non-Hispanic White women in the medium-SES group demonstrated elevated risk.Conclusions: Moderate SES is a critical risk factor for multimorbidity. Lifestyle interventions effectively reduce disease burden, particularly in middle-SES populations, with targeted protection needed for middle-aged non-Hispanic White women. Additionally, heightened vigilance is warranted regarding the expanding disease risks among young and middle-aged populations, alongside advocating for robust research initiatives to optimize evidence-based public health interventions.","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"32 Spec. No. 6","pages":"eSP22-eSP32"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201016","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

Local implementation of the national opioid settlements: challenges and opportunities. 国家阿片类药物解决方案的地方实施：挑战和机遇。

IF 2.1 4区医学

American Journal of Managed Care Pub Date : 2026-06-01 DOI: 10.37765/ajmc.2026.89943

Alyssa Altstaedter, Amy Yeung, Dennis P Scanlon

{"title":"Local implementation of the national opioid settlements: challenges and opportunities.","authors":"Alyssa Altstaedter, Amy Yeung, Dennis P Scanlon","doi":"10.37765/ajmc.2026.89943","DOIUrl":"10.37765/ajmc.2026.89943","url":null,"abstract":"The opioid epidemic is a significant public health crisis in the US. The recent national opioid settlements have provided financial resources to abate the crisis; however, several questions have emerged regarding the administrative process of fund use, how Pennsylvania and external stakeholders are allocating the funds, what motivates them, what challenges they face, and what the future of the opioid crisis holds. To understand the firsthand experiences of various stakeholders involved in the national opioid settlement, 15 semistructured interviews were conducted via Zoom between July 2024 and October 2024. Interviews addressed comparisons to the tobacco settlement, administration and use of funds, barriers to program evaluation and implementation, and future directions for the opioid crisis. Key emergent themes included tensions between county and administrative stakeholder groups, challenges in applying the guidelines created by the national opioid settlement to community-level programs, and uncertainty about the future of opioid abatement. It is critical for administrative stakeholders to understand substance use disorder (SUD) treatment, prevention, and programming and to translate legal documents into applicable guidelines for public health professionals and community stakeholders. All stakeholders should continue education efforts to destigmatize people impacted by SUD. Providing local autonomy over spending funds is beneficial; however, the current administrative systems are not equipped to address the challenges that have arisen, underscoring the need for long-term, data-driven strategies to measure the impact of national opioid settlement dollars and ensure accountability.","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"32 Spec. No. 6","pages":"SP248-SP257"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201059","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

AI cannot fix a broken claims paradigm. 人工智能无法修复破损的索赔范式。

IF 2.1 4区医学

American Journal of Managed Care Pub Date : 2026-06-01 DOI: 10.37765/ajmc.2026.89958

Manijeh Berenji, Michele Kowalski-McGraw, Larry Ozeran, Richard Schreiber

引用次数: 0

Association of travel nursing with quality outcomes in hospitalized patients. 旅行护理与住院患者预后质量的关系。

IF 2.1 4区医学

American Journal of Managed Care Pub Date : 2026-06-01 DOI: 10.37765/ajmc.2026.89960

Jason Bartock, Adam Green, Raquel Nahra, Amy Bordogna, Amir Davoodi, Jean-Sebastien Rachoin

{"title":"Association of travel nursing with quality outcomes in hospitalized patients.","authors":"Jason Bartock, Adam Green, Raquel Nahra, Amy Bordogna, Amir Davoodi, Jean-Sebastien Rachoin","doi":"10.37765/ajmc.2026.89960","DOIUrl":"https://doi.org/10.37765/ajmc.2026.89960","url":null,"abstract":"Objective: To evaluate the impact of increased travel nursing on patient safety and infection outcomes.Study design: Retrospective analysis of staffing data from a large tertiary center (2019-2023).Methods: We examined associations between nurse staffing ratios, agency nurse use, hospital-acquired infections, and patient safety indicators (PSIs) using Spearman correlations, analysis of variance, and regression analyses.Results: Agency nursing shifts rose sharply from 70.9 per month (0.9% of shifts) in 2019 to 1206 per month (12.7%) in 2023 across inpatient units and the emergency department. Over that same period, PSI events increased from 7.1 to 9.3 per month, and total infections rose from 15.8 to 20.5 per month. Hospital-wide, greater reliance on agency nurses correlated with more pressure ulcers (PSI 03), postoperative acute kidney injury requiring dialysis (PSI 10), ventilator-associated pneumonia (VAP), total PSIs, and total infections. In critical care units, higher agency staffing was specifically linked to increased VAP, Clostridioides difficile infections, and overall infections. When agency nurses accounted for more than 10% of the workforce, there was an independent association with a higher number of PSIs, although not with infections.Conclusions: Rising dependence on agency nurses coincided with increased patient safety events and selected infections. Although confounding factors may contribute to this association, these findings emphasize the need for structured integration, orientation, and monitoring of temporary staff to ensure patient safety while addressing workforce shortages.","PeriodicalId":50808,"journal":{"name":"American Journal of Managed Care","volume":"32 6","pages":"e192-e197"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309274","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

Reducing GLP-1 prior authorization friction: a managed care playbook. 减少GLP-1事先授权摩擦：管理护理剧本。

IF 2.1 4区医学

American Journal of Managed Care Pub Date : 2026-06-01 DOI: 10.37765/ajmc.2026.89957

Aayush Sisodia

引用次数: 0

What do we do with these prices? ushering in the next phase of price transparency innovation in Medicare Advantage. 我们该怎么处理这些价格？引领医疗保险优势价格透明度创新的下一阶段。

IF 2.1 4区医学

American Journal of Managed Care Pub Date : 2026-06-01 DOI: 10.37765/ajmc.2026.89973

Pooja Chandrashekar, Sachin H Jain

引用次数: 0