Role and Value of the Corporate Medical Director.

The role of the Corporate Medical Director (CMD) has received increased attention during the COVID-19 pandemic and has continued to evolve. This updated guidance addresses the role and value of the CMD in: health policy, strategy, and leadership; fostering a culture of health and well-being; supporting worker health and productivity/performance; addressing mental health; collaborating on employer benefits design; developing programs for global health, travel medicine, and remote/extreme environments; overseeing on- and near-site clinics; incorporating digital technology, artificial intelligence, and telehealth in health programs; supporting critical incident preparedness and business continuity planning; addressing workplace hazards; and overseeing periodic executive health examinations.

Effect of an Artificial Intelligence Clinical Decision Support System on Treatment Decisions for Complex Breast Cancer.

Purpose: To examine the impact of a clinical decision support system (CDSS) on breast cancer treatment decisions and adherence to National Comprehensive Cancer Center (NCCN) guidelines.

Patients And Methods: A cross-sectional observational study was conducted involving 1,977 patients at high risk for recurrent or metastatic breast cancer from the Chinese Society of Clinical Oncology. Ten oncologists provided blinded treatment recommendations for an average of 198 patients before and after viewing therapeutic options offered by the CDSS.

Elimination of the Out-of-Pocket Charge for Children's Primary Care Visits: An Application of Value-Based Insurance Design.

Objective: To evaluate the impact of a value-based insurance design for primary care among children.

Study Design: A retrospective analysis of health care claims data on 25 950 children (<18 years of age) was conducted. Individuals were enrolled in a large employer's health plans when zero out-of-pocket cost for primary care physician visits was implemented.

Spatio-temporal information and knowledge representation of disease incidence and respective intervention strategies.

The supplementation of medical data with environmental data offers rich new insights that can improve decision-making within health systems and the healthcare profession. In this study, we simulate disease incidence for various scenarios using a mathematical model. We subsequently visualise the infectious disease spread in human populations over time and geographies.

Mainstreaming modeling and simulation to accelerate public health innovation.

Dynamic modeling and simulation are systems science tools that examine behaviors and outcomes resulting from interactions among multiple system components over time. Although there are excellent examples of their application, they have not been adopted as mainstream tools in population health planning and policymaking. Impediments to their use include the legacy and ease of use of statistical approaches that produce estimates with confidence intervals, the difficulty of multidisciplinary collaboration for modeling and simulation, systems scientists' inability to communicate effectively the added value of the tools, and low funding for population health systems science.

Medication utilization and adherence in a health savings account-eligible plan.

Objectives: To evaluate the impact of a consumerdirected health plan with a health savings account (CDHP-HSA) on utilization of and adherence to medications among individuals with chronic disease.

Study Design: Pre-post comparison study with matched control group (difference-in-differences analysis).

Methods: Data on workers and dependents with 1 or more of 5 chronic conditions--hypertension, dyslipidemia, diabetes, asthma/chronic obstructive pulmonary disease (COPD), and depression--were obtained from an employer that fully replaced its preferred provider organizations (PPOs) with a CDHP-HSA in 2007.

Consumer-directed health plans reduce the long-term use of outpatient physician visits and prescription drugs.

Consumer-directed health plans (CDHPs) are designed to make employees more cost- and health-conscious by exposing them more directly to the costs of their care, which should lower demand for care and, in turn, control premium growth. These features have made consumer-directed plans increasingly attractive to employers. We explored effects of consumer-directed health plans on health care and preventive care use, using data from two large employers-one that adopted a CDHP in 2007 and another with no CDHP.

Large employers that have lived through transformation say payment reform alone won't cut costs and reengineer care.

As payment reform in health care gathers momentum, employers, as major payers, endorse the effort to move away from volume-driven payment to incentivizing and rewarding the delivery of better health care at lower cost. In this commentary we discuss large employers' perspectives on three particular challenges that payment reform alone, as important as it is, may not be sufficient to address: high health care prices, inefficient and complex systems, and an outdated work environment ill designed to meet the pressing goals of better health care at lower cost. We believe that policies that support health care organizations in redesigning work processes will be essential to reducing prices and simplifying interactions in care delivery.

An observational study of an employer intervention for children's healthy weight behaviors.

Objective: This observational study was undertaken to assess whether changes in healthy weight behaviors could be advanced in a short-term intervention involving parents and children at IBM.

Methods: IBM's Children's Health Rebate offered a cash incentive for parents to complete a 12-week program of self-selected activities in family food planning and meals, family physical activity, and sedentary time related to electronic entertainment ("screen time"). A preprogram/postprogram comparison of self-reported activities was used to assess behavior change.

Impact of childhood obesity on employers.

The impact of childhood obesity on the workplace is not well understood. A study conducted for one large employer indicated that average per capita health insurance claims costs were as high as $2,907 in 2008 for an obese child and $10,789 for a child with type II diabetes. The average claims cost for children with type II diabetes actually exceeded the level of the average claims cost for adults with type II diabetes ($8,844).

Evaluating the tools used to assess the medical home.

Purpose: The patient-centered medical home is evolving as an approach to providing primary care. Primary care is defined by four main characteristics: comprehensive, coordinated, continuous, and accessible care, all of which are measurable. This analysis identifies tools for determining whether a patient-centered medical home achieves high level primary care.

Primary care: can it solve employers' health care dilemma?

Employers are beginning to recognize that investing in the primary care foundation of the health care system may help address their problems of rising health care costs and uneven quality. Primary care faces a crisis as a growing number of U.S.