To improve availability of primary health care and to strengthen a preventive trend in public health, the authors propose a model for organizing medical aid within the concept of the occupational health system adopted by the Sverdlovsk Regional Government under No. 73-[Russian characters: see text] on February 2, 2004, which is being implemented at the municipal level, namely in the Berezovsky City District.
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Am J Manag Care
January 2025
Health Economics Resource Center, VA Palo Alto Health Care System, 795 Willow Rd, Menlo Park, CA 94025. Email:
Objectives: Unused medical appointments affect both patient care and clinic operations, and the frequency of cancellations due to clinic reasons is underreported. The prevalence of these unused appointments in primary care in the Veterans Affairs Health Care System (VA) is unknown. This study examined the prevalence of unused primary care appointments and compared the relative frequency of cancellations and no-shows for patient and clinic reasons.
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January 2025
McGovern Medical School at UTHealth Houston, 4513 Teas St, Bellaire, TX 77401.
Objective: To examine the effect of physiologic insulin resensitization (PIR) on the cost of treating patients with diabetes and chronic kidney disease (CKD).
Study Design: The mean 1-year cost of treating 66 Medicare Advantage patients with diabetes and CKD who were receiving PIR was compared with that of treating 1301 Medicare Advantage patients with diabetes and CKD not receiving PIR. Differences in disease severity were compared using mean risk adjustment factor scores.
Am J Manag Care
January 2025
Schaeffer Center for Health Policy & Economics, University of Southern California, 635 Downey Way, Verna & Peter Dauterive Hall, Los Angeles, CA 90089. Email:
Objectives: To assess trends in the medical loss ratio (MLR) and understand how health insurance premiums in the large group market are driven by medical claims spending and insurer margins.
Study Design: Study of approximately 500 insurers covering more than 40 million lives annually in the large group market that submitted an MLR submission form (2014-2022).
Methods: We assessed trends in the MLR, premiums, medical claims spending, administrative costs, quality improvement spending, and margins among all insurers in the large group market.
Am J Manag Care
January 2025
Ascension Borgess Hospital, 345 Naomi St, Plainwell, MI 49080. Email:
Objective: To describe the outcomes of a partnership between a drug plan and pharmacists to switch patients from brand name dipeptidyl-peptidase-4 inhibitors to the generic alogliptin.
Study Design: Single-center, retrospective chart review.
Methods: Clinical pharmacists contacted patients with primary care providers within the health system affiliated with the drug plan to facilitate the switch.
Am J Manag Care
January 2025
Department of Orthopedic Surgery, Duke University School of Medicine, 311 Trent Dr, Durham, NC 27710. Email:
Objectives: 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.
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