The American journal of managed care
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Randomized Controlled Trial
Impact of a managed controlled-opioid prescription monitoring program on care coordination.
Inappropriate opioid medication utilization has grown tremendously in recent years. Managed care organizations have the opportunity to identify potential opioid misuse and implement care coordination interventions. ⋯ This intervention provided action-able information to prescribers regarding member opioid utilization, in addition to available managed care resources. It resulted in significantly greater reductions in the number of prescribers, pharmacies, and prescriptions compared with a general information letter notifying prescribers of available managed care resources. Implementation of this intervention has the potential to enhance coordination of care for members potentially at risk for poor health outcomes.
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To evaluate the appropriateness of the definition of outpatient-shopping behavior in Taiwanese patients. ⋯ Health authorities should consider charging additional fees after a specific outpatient- shopping threshold is reached to reduce this behavior. The government may need to reassess the function of the medical sources network by shrinking it from the original 4 levels to 2 levels, or by enhancing the referral function among different hospital levels.
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The Robert Wood Johnson Foundation's (RWJF's) Aligning Forces for Quality (AF4Q) initiative is the largest privately funded community-based quality improvement initiative to date, providing funds and technical assistance (TA) to 16 multi-stakeholder alliances located throughout the United States. The objectives of this article are to describe the AF4Q initiative's underlying theory of change, its evolution over time, and the key activities undertaken by alliances. ⋯ The AF4Q initiative is an ambitious program affecting multiple leverage points in the healthcare system. AF4Q alliances were provided a similar set of expectations and given access to substantial TA. While participating alliances have made progress in addressing the AF4Q programmatic areas, given differences in the alliances' composition, market structure, and history, there is considerable variation in program implementation.
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The systematic collection and use of race/ethnicity and language (REL) data by healthcare organizations has long been recognized as a critical step to reducing healthcare disparities locally and nationally. We seek to identify the challenges and opportunities in implementing community-level interventions to collect REL data for detecting and reducing disparities in care in the 14 multi-stakeholder communities participating in the Aligning Forces for Quality initiative. ⋯ Community-level efforts to collect REL data require securing buy-in from organizational leadership, developing a dialogue across the community, and generating awareness across key players about disparities-reduction efforts, especially REL data collection, without alienating patients, communities, and providers.