The American journal of managed care
-
Despite chronic cough being one of the most frequent reasons for both primary care and specialty physician visits, its diagnosis and treatment remain challenging. The most common causes are upper airway cough syndrome, asthma, and gastroesophageal reflux disease; however, new research has implicated a cough hypersensitivity syndrome that may link many underlying etiologies. To accurately diagnose and treat patients with chronic cough, a thorough understanding of the various definitions, epidemiology, and pathophysiology is crucial. This article reviews these factors as well as the healthcare and socioeconomic burden of chronic cough.
-
In the midst of the coronavirus disease 2019 (COVID-19) pandemic, health care leaders must work to optimize emergency department and hospital efficiency while maintaining patient access to care.
-
To mark the 25th anniversary of the journal, each issue in 2020 will include an interview with a health care thought leader. The October issue features a conversation with Kavita K. Patel, MD, MS, nonresident fellow at The Brookings Institution and editorial board member of AJMC®.
-
Innovative value strategies for reimbursement of medications include value-based agreements (VBAs) between payers and pharmaceutical manufacturers, which have the potential to improve affordability and patient access to therapy, as well as lead to a reduction in downstream health events and associated medical costs. VBAs link payment for a medication to its performance in real-world clinical practice measured against prespecified outcomes that are aligned to existing evidence. ⋯ Between 2015 and 2018, 11 contract-years of VBAs utilizing this framework were implemented in commercial and Part D health insurance plans, totaling nearly 32,000 unique patients in which pooled analyses were conducted. Aggregated VBA results indicate that ticagrelor consistently outperformed expectations in reducing recurrent MI vs clopidogrel, while also illustrating how comparative VBA frameworks of this nature may overcome challenges noted for VBAs and be utilized more broadly in future applications.
-
To assess the association of geriatric syndrome risk factors with postacute utilization among hospitalized Medicare patients (both Medicare Advantage [MA] and fee-for-service [FFS] cohorts) and to examine patterns of postacute care for MA and FFS cohorts with high geriatric syndrome risk. ⋯ Geriatric syndrome risk factors not only play a role in postacute care and inpatient utilization in MA and FFS cohorts but also explain different utilizations between MA and FFS cohorts. This study's results can be applied to guide discharge planning among a group of high-risk patients and evaluate alternative delivery models for this high-cost, high-need cohort.