Impact of hospital-physician vertical integration on physician-administered drug spending and utilization.

We estimate the effects of hospital-physician vertical integration on spending and utilization of physician-administered drugs for hematology-oncology, ophthalmology, and rheumatology. Using a 100% sample of Medicare fee-for-service medical claims from 2013 to 2017, we find that vertical integration shifts treatments away from physician offices and toward hospital outpatient departments. These shifts are accompanied by increases in physician-administered drug administration spending per procedure for all three specialties.

Financial Interventions to Improve Screening in Primary Care: A Systematic Review.

Introduction: Although health screenings offer timely detection of health conditions and enable early intervention, adoption is often poor. How might financial interventions create the necessary incentives and resources to improve screening in primary care settings? This systematic review aimed to answer this question.

Methods: Peer-reviewed studies published between 2000 and 2023 were identified and categorized by the level of intervention (practice or individual) and type of intervention, specifically alternative payment models (APMs), fee-for-service (FFS), capitation, and capital investments.

Are disparities in mental health care for Medicaid beneficiaries lower in managed care?

Background: There are large and persistent racial and ethnic disparities in the use of mental health care in the United States. Medicaid managed care plans have the potential to reduce racial and ethnic disparities in use of mental health care through monitoring of need and active management of use of services across the populations they cover. This study compares racial and ethnic disparities among Medicaid beneficiaries in managed care with those not in managed care.

The effect of adverse childhood experience training, screening, and response in primary care: a systematic review.

Background: Adverse childhood experiences (ACEs) can have harmful, long-term health effects. Although primary care providers (PCPs) could help mitigate these effects, no studies have reviewed the impacts of ACE training, screening, and response in primary care.

Methods: This systematic review searched four electronic databases (PubMed, Web of Science, APA PsycInfo, CINAHL) for peer-reviewed articles on ACE training, screening, and/or response in primary care published between Jan 1, 1998, and May 31, 2023.

Psychiatric and Substance Use Disorder Bed Capacity, Need, and Shortage Estimates in California: Merced, San Joaquin, and Stanislaus Counties.

Psychiatric and substance use disorder (SUD) treatment beds are essential infrastructure for meeting the needs of individuals with behavioral health conditions. However, not all psychiatric and SUD beds are alike: They represent infrastructure within different types of facilities. For psychiatric beds, these vary from acute psychiatric hospitals to community residential facilities.

Association between hospital-physician vertical integration and medication adherence rates.

Objective: To test the association between vertical integration of primary care providers (PCPs) and adherence rates for anti-diabetics, renin angiotensin system antagonists (RASA), and statins.

Data Sources: Medicare Part B outpatient fee-for-service claims and Medicare Part D event data from 2014 to 2017.

Study Design: We estimated difference-in-differences regressions, comparing changes in adherence among patients with PCPs who converted from independent to integrated to changes among patients whose PCPs remained independent or integrated during the study period.

New prescription fills of selective serotonin reuptake inhibitors before and during the COVID-19 pandemic in Los Angeles County, California.

Objective: This study examined whether the COVID-19 pandemic was associated with changes in new selective serotonin reuptake inhibitor (SSRI) prescription fills.

Methods: Using IQVIA Xponent data on new SSRI fills in Los Angeles (L.A.

Differences in buprenorphine treatment quality across physician provider specialties.

Background: The number and types of clinicians prescribing buprenorphine treatment for opioid use disorder (OUD) have increased over the past two decades, but there is little information on how potential indicators of quality of care to patients receiving buprenorphine vary by provider specialty.

Methods: We used the Medicaid Analytic eXtract from 2009 to 2014 to identify buprenorphine treatment episodes. We assigned physician specialties to episodes based on whether an episode had at least one outpatient claim linked to specialists in addiction, behavioral health, opioid treatment program (OTP), pain, or primary care provider (PCP).

Sociodemographic differences in quality of treatment to Medicaid enrollees receiving buprenorphine.

Buprenorphine is a key medication to treat opioid use disorder, but little is known about how treatment quality varies across sociodemographic groups. Objective: We examined measures of treatment quality and explored variation by sociodemographic factors. We used Medicaid MAX data from 50 states from 2006 to 2014 to identify buprenorphine treatment episodes ( = 317,494).

Cost-effectiveness of total state coverage for hepatitis C medications.

Objectives: Most Medicaid beneficiaries with hepatitis C virus (HCV) are not treated with direct-acting agents because of budget constraints, but they experience costly complications after becoming Medicare eligible. Maryland's "total coverage" proposal could receive a credit from Medicare to offset Medicaid investments in treatments that could lead to Medicare savings. This study analyzes the cost-effectiveness and budget impact of total coverage for HCV treatments sponsored by state Medicare and Medicaid.

Does Incorporating Cost-Effectiveness Analysis Into Prescribing Decisions Promote Drug Access Equity?

Using cost-effectiveness analysis (CEA) to inform prescribing can promote equitable drug access from a utilitarian perspective. Some theorists of equity, such as Rawls or Powers and Faden, however, would not consider CEA as promoting equity, as they endorse nonutilitarian theories of equity. Novel advances in CEA methodology seek to integrate broader equity concerns but may raise transparency concerns.

Use and cost of disease-modifying therapies by Sonya Slifka Study participants: has anything really changed since 2000 and 2009?

Background: Disease-modifying therapies benefit individuals with relapsing forms of multiple sclerosis, but their utility remains unclear for those without relapses.

Objective: To determine disease-modifying therapy use and costs in 2009, compare use in 2009 and 2000, and examine compliance with evidence-based guidelines.

Methods: We determined the extent and characteristics of disease-modifying therapy use by participants in the Sonya Slifka Longitudinal Multiple Sclerosis Study (Slifka) in 2000 (=2156) and 2009 (=2361) and estimated out-of-pocket and total (payer) costs for 2009.