The American journal of managed care
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To examine the effect of physiologic insulin resensitization (PIR) on the cost of treating patients with diabetes and chronic kidney disease (CKD). ⋯ PIR is a possible method of reducing the cost of treating patients with diabetes and CKD. Given the rapidly increasing numbers of patients with diabetes and CKD who are Medicare Advantage beneficiaries, PIR should be considered for use by managed care organizations.
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Patients are often discharged to a skilled nursing facility (SNF) for postacute rehabilitation. Functional outcomes achieved in SNFs are variable, and costs are high. Especially for accountable care organizations (ACOs), home-based postacute rehabilitation offers a high-value option if outcomes are not compromised. The objective was to compare outcomes for episodes in a novel high-intensity home-based rehabilitation (HIHR) model vs an SNF. ⋯ The HIHR cohort demonstrated better functional outcomes and lower posthospital costs. HIHR may be a high-value option for patients attributed to a Medicare ACO who have moderate medical complexity and moderate functional deficits at the time of hospital discharge.
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Historical Article
Managed care reflections: a Q&A with Jan E. Berger, MD, MJ.
To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed-and what has not-over the past 3 decades and what's next for managed care. The January issue features a conversation with longtime editorial board member Jan E. Berger, MD, MJ, the CEO of Health Intelligence Partners.
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The authors advocate for the implementation of value-based principles to address the underutilization and limited supply of home care and rehabilitation services.
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Patient experience surveys are essential to measuring patient-centered care, a key component of health care quality. Low response rates in underserved groups may limit their representation in overall measure performance and hamper efforts to assess health equity. Telephone follow-up improves response rates in many health care settings, yet little recent work has examined this for surveys of Medicare enrollees, including those with Medicare Advantage. Our objective was to describe response rates to the 2022 Medicare Consumer Assessment of Healthcare Providers and Systems (MCAHPS) surveys and the completion mode (mail or telephone), overall and by person-level characteristics. ⋯ Including a telephone component in the administration of the MCAHPS survey continues to have value because several groups still show a relative preference for survey completion by telephone. Steps should be taken to improve response rates by telephone.