Tacking upwind: reducing spending among high-risk commercially insured patients.

Objectives: The study examined a commercial accountable care organization (ACO) population and then assessed the impact of an integrated care management program on medical spending and clinical event rates.

Study Design: Retrospective cohort study of high-risk individuals (n = 487) in a population of 365,413 individuals aged 18 to 64 years within the Mass General Brigham health system who were part of commercial ACO contracts with 3 large insurers between 2015 and 2019.

Methods: Using medical spending claims and other enrollment data, the study assessed the demographic and clinical characteristics, medical spending, and clinical event rates of patients in the ACO and its high-risk care management program.

Population turnover and leakage in commercial ACOs.

Objectives: Commercial accountable care organization (ACO) contracts attempt to mitigate spending growth, but past evaluations have been limited to continuously enrolled ACO members in health maintenance organization (HMO) plans, excluding many members. The objective of this study was to examine the magnitude of turnover and leakage within a commercial ACO.

Study Design: A historical cohort study using detailed information from multiple commercial ACO contracts within a large health care system between 2015 and 2019.

Septic arthritis of the knee due to Streptococcus anginosus.

A case of arthritis caused by Streptococcus anginosus was observed in which the only predisposing factor was osteoarthritis of the knee and an acute meniscal tear. We report here the fifth case of septic arthritis due to Streptococcus anginosus.

Malignant lymphocytic lymphoma. Demonstration of a serum inhibitor of myelopoiesis and response to combination chemotherapy.

A case of diffuse well differentiated lymphocytic lymphoma with associated leukopenia, is described. The colony-forming unit (CFU-C) assay was used to quantitate myeloid precursor cells and to test for the presence of suppressor cells and/or serum factors inhibiting myeloid cell proliferation. Mild suppression of CFU-C was noted with the patient's bone marrow cells in coculture studies with normal marrow.

Studies of Fc gamma receptors of human B lymphocytes: phospholipase A2 activity of Fc gamma receptors.

The presence of phospholipase A2 activity within human B cell Fc gamma receptors was investigated. Lysate produced by detergent treatment of chronic lymphocytic leukemia cells that had 1% of the cells surface radioiodinated was subjected to affinity chromatography by using either rac-1-(9-carboxynonyl)-2-hexadecylglycero-3-phosphorylcholine-Sepharose (PC-Sepharose) or heat-aggregated human IgG-Sepharose 4B conjugate (IgG-Sepharose). The materials eluted from both adsorbants by ethylenediaminetetraacetate- or urea-containing buffer were further purified by gel filtration and isoelectric focusing in the presence of 6 M urea.