The American journal of managed care
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Schizophrenia is a chronic mental health disorder hallmarked by a variety of symptoms impacting mental state, emotions, and behaviors, including delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms, and cognitive impairment. Schizophrenia leaves patients with the inability to function appropriately in their daily lives, including at work, in relationships, and even with self-care. ⋯ Schizophrenia is estimated to affect more than 21 million individuals globally, and while many therapies have become available for management, the disorder still presents unique challenges to providers, caregivers, and the healthcare system. Unmet medical needs remain for this complex disease state, and research is ongoing to address these needs and improve the overall health and outcomes of patients living with schizophrenia.
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To mark the 25th anniversary of the journal, each issue in 2020 will include an interview with a healthcare thought leader. For the March issue, which marks the 10th anniversary of the Affordable Care Act being signed into law, we turned to Representative Frank Pallone Jr, D-New Jersey, who played a key role in the law's writing and passage.
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To develop and validate predictive models for imminent fracture risk in a Medicare population. ⋯ Recent fracture, older age, female sex, white race, falls, and antidepressant/antipsychotic/sedative hypnotic/muscle relaxant medications predict imminent fracture risk in an older-adult Medicare Advantage population. Imminent fracture risk can be assessed using 6 easily quantified factors.
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To examine differences in the out-of-pocket costs for common generic drugs used to treat chronic conditions when individuals used their Medicare prescription drug plan (PDP) or when purchased through Walmart's generic drug discount programs (GDDPs) from 2009 to 2017. ⋯ Although Medicare beneficiary out-of-pocket costs for commonly used generic drug prescriptions generally decreased over time, Medicare beneficiaries may still be paying more for the same drugs than they would through Walmart's GDDP. Increased generic drug price transparency, including enforcing bans on gag clauses, is needed to ensure that Medicare beneficiaries obtain drugs using the most affordable options.
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To examine the effects of MD-Value in Prevention (MDVIP) enrollment on Medicare expenditures and utilization among fee-for-service (FFS) beneficiaries with diabetes over a 5-year period. ⋯ Our finding of reduced unplanned inpatient admissions and ED utilization supports the previous findings regarding MDVIP enrollees. We did not find significant changes in overall third-party expenditures, although savings were estimated in year 5, the last year of observation, and may occur later. Our approach, however, strengthens controls for baseline characteristics of the population and uses a comparison population drawn from the same markets who do not experience the loss of their primary care physician at the time of enrollment.