Prior Authorization for Elective Diagnostic Catheterization: The Value of Reviewers in Cases with Clinical Ambiguity
Adam C. Powell, PhD, Stephen E. Price, DPT, MBA, Khoa Nguyen, MS, Gary L. Smith, MS, James W. Long, BSBA, Uday U. Deshmukh, MD, MPH
For much of modern history, physicians have made decisions about patient care by consulting their peers and by using rule-based approaches. Specialists have been consulted throughout history and became a necessity in the 1800s, as medicine became more complex.
Standardized Documentation Can Improve Diagnostic Testing Decisions for Patients with Cardiovascular Disease
Long-Term Outcomes of a Cardiovascular and Diabetes Risk-Reduction Program Initiated by a Self-Insured Employer
Nicole D. White, PharmD, CDE, Thomas L. Lenz, PharmD, FACLM, Maryann Z. Skrabal, PharmD, CDE, Jessica J. Skradski, PharmD, Louis Lipari
Cardiovascular disease (CVD) remains the leading cause of death in America, resulting in approximately 610,000 deaths each year. The prevalence of CVD in the United States is increasing.
Influencing Patient Outcomes Through Enhanced Multidisease-Focused Interventions
Treatment Persistence and Healthcare Costs Among Patients with Rheumatoid Arthritis After a Change in Targeted Therapy
Machaon M.K. Bonafede, PhD, MPH, Donna McMorrow, BS, Clare Proudfoot, PhD, Shraddha Shinde, MS, MBA, Andreas Kuznik, PhD, Chieh-I Chen, MPH
This retrospective analysis is based on inpatient medical claims, outpatient medical claims, and pharmacy claims from the Truven Health MarketScan Commercial Database. The database includes claims for approximately 35 million employees and their dependents in fee-for-service and managed care health plans.
End-stage renal disease (ESRD), also known as stage 5 kidney disease, is characterized by permanent kidney failure. Currently, more than 678,000 Americans have ESRD, and projections indicate that the population of patients with this disease may exceed 2 million by 2030.
Dialysis Procedures and Health-Related Quality of Life: The Challenge of Creating Evidence-Based Healthcare in End-Stage Renal Disease
Changes in Medical Services and Drug Utilization and Associated Costs After Narcolepsy Diagnosis in the United States
Narcolepsy is a chronic, disabling sleep disorder characterized by excessive daytime sleepiness and recurrent periods of sudden, unintentional lapses into sleep during the day. This condition may occur with or without cataplexy, an abrupt and typically bilateral loss of skeletal muscle tone that is often triggered by strong emotion that, when severe, may cause the patient to briefly collapse without losing consciousness.
Accurate Diagnosis of Chronic Diseases Can Reduce Costs and Medical Resource Utilization
Delayed Treatment Acceleration in Patients with Rheumatoid Arthritis Who Have Inadequate Response to Initial Tumor Necrosis Factor Inhibitors: Data from the Corrona Registry
Dimitrios A. Pappas, MD, Robert A. Gerber, PharmD, Heather J. Litman, PhD;, David Gruben, PhD, Jamie Geier, PhD, Winnie D. Hua, MS, Connie Chen, PharmD, Youfu Li, MD, MPH, Joel M. Kremer, MD, John S. Andrews, MD, Jeffrey A. Bourret, PharmD
Effects of Educational Messaging on Urgent and Emergent Care–Seeking Behaviors Among Publicly Insured Populations
Jesse Cambon, MEng, Tristan Cordier, MS, Elizabeth L. Munnich, PhD, MPP, Andrew Renda, MD, Bobby Kapur, MD, MPH, Shkelzen Hoxhaj, MD, MPH, MBA, Meredith Williams, MD, MBA
Narrow network plans offer limited provider choice, but they are attractive to premium-sensitive healthcare consumers, because premiums and out-of-pocket costs are lower than plans with broader provider networks. However, the intended cost-savings for individuals and health
Opportunities to Improve Urgent and Emergent Care Utilization
Patient Preferences and Therapeutic Satisfaction with Topical Agents for Rosacea: A Survey-Based Study
Temporal Trends in Survival and Healthcare Costs in Patients with Multiple Myeloma in the United States
Approximately 30,000 new cases of multiple myeloma are diagnosed annually in the United States, and 12,650 deaths annually are attributed to multiple myeloma.
Improved Clinical Outcomes with Newer Multiple Myeloma Therapies Associated with Increased Resource Utilization and Financial Burden
Prospective Bundled Payments in a Changing Environment: The Experience of a Self-Funded, State-Sponsored Plan
For decades, healthcare reimbursement has been based on the quantity of services delivered. Because of the perceived risks of physician and facility self-interests driving increased utilization, there has been a movement toward value-based reimbursement, which is supposed to balance treatment effectiveness, cost, and cost-effectiveness.
Oklahoma Benefits Program Setting an Example: A Cost-Effective Bundled Payments Option for State Employees
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Results 1 - 10 of 41
Results 1 - 10 of 41