Scientific studies relating to the cost and effectiveness of programs, products, and procedures in health care financing and delivery. Newest articles are listed first. To submit an article for publication in Managed Care magazine, see the Call for Papers.
Effect of Social Work Intervention On Hospital Discharge Transition Planning In a Special Needs Population
Alan Adler, MD, MS, Craig Lipkin, MS, Lisa Cooper, MSW, Michael Agolino, MSW, Violet Jones, RN
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Hypertension Epidemiology and Economic Burden: Refining Risk Assessment To Lower Costs
Jerome D. Cohen, MD
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Effect of Patient Medication Cost Share on Adherence and Glycemic Control
Higher cost sharing decreases adherence to oral diabetes drugs and worsens glucose levels
Jacquelyn Hunt, PharmD, MS, BCPS , Yelena Rozenfeld, MPH, Rahul Shenolikar, BS Pharm, PhD
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Evaluating the Tools Used to Assess the Medical Home
Nine instruments were reviewed based on the extent that they measured the four attributes of primary care. Only one fully met the recommended criteria.
Rebecca A. Malouin, PhD, MPH, Barbara Starfield, MD, MPH, Martin Jose Sepulveda, MD
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Barriers to Breast Cancer Screening In a Managed Care Population
Sharp Health Plan wanted to increase mammography screening for its at-risk female population. Thirty percent of at-risk members were non-adherent. Members’ reasons for avoiding screening were examined.
Sandra R. Parkington, MPH, RN, Nora Faine, MD, MPH, Marcia C. Nguyen, Michelle T. Lowry, MPH, Poorva A. Virginkar
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Effect of Drug Therapy on HEDIS Measurements of HbA1c Control In Diabetes Patients
Gary Bazalo, MS, MBA, Richard Weiss, MS, Nathaniel Clark, MD, Berhanu Alemayehu, PhD, Felicia Forma, Garrett Ingram ME
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Nausea and Vomiting of Pregnancy: Cost Effective Pharmacologic Treatments
James P. Reichmann, MBA, Michael S.Kirkbride, BSc, Pharm D
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Loss of Confidence in Diabetes Management
Patricia R. Salber, MD, MBA, William Bestermann, MD, Stanley Schwartz MD, Albert Marchetti, MD
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Evaluation of a Continuous Glucose Monitoring System for Home-Use Conditions
Bruce Bode, MD, Michael Silver, MD, Richard Weiss, MS, Kathryn Martin, PharmD
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Health Plan Joins With Physical Therapy Facility to Manage Back and Neck Pain
Capital Health Plan achieved a 79% improvement in pain scores and a 54% improvement in function scores for its members
Charles M. Tomlinson, MD, Chad Gray, PT, Tom Kane, PT
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Using Option-Based Contracts to Improve Health Outcomes
A system in which individual insurance policies may be purchased for separate medical products and services is based on a medical options market and takes its cue from the financial sector
Damon Douglas, dual PharmD/MBA candidate
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In Chronic Disease, Nationwide Data Show Poor Adherence by Patients to Medication and by Physicians to Guidelines
A widespread approach that incorporates various stakeholders may be necessary to change adherence behavior
Sara L. Thier, MPH, Kristina S. Yu-Isenberg, PhD, MPH, RPh, Brian F. Leas, MS, MA, C. Ron Cantrell, PhD, Sandra DeBussey, Neil I. Goldfarb
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Optimizing the Use of 17P In Pregnant Managed Medicaid Members
Mary V. Mason, MD, MBA, Kara M. House, MBA, Janice Linehan, PA-C, MHP, Carol A. Speers, RN, Lisa M. Joseph, RN, MBA, Ray Littlejohn
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Evolution of TennCare Yields Valuable Lessons
The old TennCare program had many flaws and detractors. Its near collapse led to a more realistic approach to providing coverage to the uninsured in Tennessee.
Cyril F. Chang, PhD
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Comparison of Human Growth Hormone Products' Cost in Pediatric and Adult Patients
Payers' drug costs for human growth hormone are related to product waste that is related to the container in which the product is supplied
Gary R. Bazalo, MS, Ashish V. Joshi, PhD, John Germak, MD
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Determining the Cost-Effectiveness of a Computer-Based Smoking Cessation Intervention in Primary Care
Meredith Y. Smith, PhD, Purdue Pharma, Stamford, Conn., Jerry Cromwell, PhD, Research Triangle Institute, Research Triangle Park, N.C., Judith DePue, EdD, Miriam Hospital/Brown Medical School, Providence, R.I., Bonnie Spring, PhD, Northwestern University, Chicago, Ill., William Redd, PhD, Mount Sinai School of Medicine, New York, N.Y., Marina Unrod, PhD, Mount Sinai School of Medicine, New York, N.Y.
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The Appropriate Omalizumab Patient
Management of the uncontrolled asthma patient and case examples
Jill Karpel, MD, Donald A. Bukstein, MD, Robert LoNigro
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Applying the Planned Care Model To Intimate Partner Violence
Implementing what was formerly called the Chronic Care Model can improve an organization's response to this widespread problem
Therese Zink, MD, MPH, Karen Lloyd, PhD, LP, George Isham, MD, David J. Mathews, PsyD, LICSW, Terry Crowson, MD
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The Use of Therapeutic Interchange For Biologic Therapies
Joseph Flood, MD, FACR, Charles Mihalik, PharmD, RPh, Renee R. Fleming, RPh, MBA, Bruce E. Strober, MD, PhD, Deborah R. Zucker, MD, PhD, Douglas S. Burgoyne, PharmD, RPh
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Implementing Disease Management Programs for Type 2 Diabetes in Germany
Germany has been able to enroll more than a million people with type 2 diabetes in DM programs through legislation that created incentives for physicians and insurers
Heinz Nagel, MD, Thomas Baehring, PhD, Werner A. Scherbaum, MD, PhD
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Compliance With Antithrombotic Guidelines: Current Practice, Barriers, and Strategies For Improvement
Deeply held, but not evidence-based, concerns about the possible risks of pharmacologic prophylaxis leave many patients at risk for DVT
Joseph A. Caprini, MD, Thomas M. Hyers, MD, FCCP
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When Overcrowding Paralyzes an Emergency Department
Changing the process and mindset of health care professionals was the key to reducing emergency department overcrowding
Joseph R. Twanmoh, MD, FACEP, Gail P. Cunningham, MD, FACEP
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The Cost-Effectiveness of Omega-3 Supplements For Prevention of Secondary Coronary Events
Dietary supplementation with omega-3 fatty acids in U.S. males is associated with fewer cardiovascular fatalities and lower costs
Jordana K. Schmier, MA, Nancy J. Rachman, PhD, Michael T. Halpern, MD, PhD
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The Cost Benefit to Health Plans of Pharmacotherapy for Alzheimer's Disease
As with other chronic diseases of aging, early diagnosis and pharmacologic therapy may reduce the costs for enrollees with Alzheimer's disease
David S. Geldmacher, MD
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17 Alpha-Hydroxyprogesterone Caproate (17P) Usage in a Medicaid Managed Care Plan and Reduction in Neonatal Intensive Care Unit Days
Offering 17P as a benefit to pregnant women enrollees with a history of preterm delivery can reduce NICU days significantly for a Medicaid plan.
Mary V. Mason, MD, MBA, Kara M. House, BS, MBA, Cathy M. Fuest, RPh, Deborah R. Fitzgerald, RN, Bonnie J. Kitson, MBA, Jacqueline A. Inglis, RN, BSN, MM
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Evaluating the Nondrug Costs of Formulary Coverage Restrictions
Substantial nondrug costs result from switching prescribed medications in response to changes in insurance coverage, and many nonreimbursed costs shift to providers and patients.
Paul Abourjaily, PharmD, William A. Gouveia, MS, Harry P. Selker, MD, MSPH, Deborah R. Zucker, MD, PhD
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Consumer-Directed Health Plans: Enrollee Views, Early Employer Experience
As CDHPs increasingly penetrate the commercial market , their greatest contribution might lie in funding health services for retirees and in reducing the number of uninsured people by offering affordable insurance.
Janice Frates, PhD, Ellen Severoni, RN
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Clinical and Economic Effects of Coronary Restenosis After Percutaneous Coronary Intervention in a Managed Care Population
This study is the first to estimate costs and medical resource use associated with restenosis involving bare metal stents in managed care percutaneous coronary intervention patients.
Mary Ann Clark, MHA, Ameet Bakhai, MD, Elise M. Pelletier, MS, David J. Cohen, MD, MSc
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Managing Drugs for Rare Genetic Diseases: Trends and Insights
This article evaluates recent trends and challenges in health system management of exceedingly rare genetic diseases, from the perspective of the manufacturer, managed care organization, physician, and actuary.
Mark Zitter, MBA
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Measuring Outpatient Outcomes of Emesis and Nausea Management in Pregnant Women
In this study, outpatient management was effective in controlling nausea and vomiting during pregnancy and was associated with a reduced need for hospital or emergency room treatment as well as reduced costs.
David G. Lombardi, MD, Niki B. Istwan, RN, Debbie J. Rhea, MPH, John M. O'Brien, MD, John R. Barton, MD
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Evaluating New Therapies for Psoriasis
Thomas Morrow, MD
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Improving Physician Attendance At Educational Seminars Sponsored By Managed Care Organizations
Although interactive educational seminars that target physicians require a large investment of resources, they can be cost-effective if medical care is improved as a result.
Michael D. Cabana, MD, MPH, Randall Brown, MD, MPH, Noreen M. Clark, PhD, Diane F. White, RRT, Juanita Lyons, PhD, Sylvia Wanner Lang, PhD
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Cost-effective Management of Hyperglycemia in Patients With Type 2 Diabetes Using Oral Agents
Udaya M. Kabadi, MD
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Advances in Migraine Management: Implications for Managed Care Organizations
David W. Dodick, MD, Robert J. Lipsy, PharmD
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IgE-Blocking Therapy for Difficult-to-Treat Asthma: A Brief Review
Gailen D. Marshall Jr., MD, PhD, Christine A. Sorkness, PharmD
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Improving Oral Pharmacologic Treatment And Management of Type 2 Diabetes
George E. Dailey III, MD
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Treating Psoriasis Patients With Biologic Agents
David M. Pariser, MD, Jeffrey Lenow, MD, JD
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Case Study of a Failed Merger of Hospital Systems
Jaan Sidorov, MD
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Balancing the Health Care Scorecard
Judith A. Shutt
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Managing Perinatal Outcomes: The Clinical Benefit and Cost-Effectiveness of Pharmacologic Treatment of Recurrent Preterm Labor
Fung Lam, MD, Niki B. Istwan, RN, BS, Debbie Jacques, MPH, Suzanne K. Coleman, RNC, MS, Gary J. Stanziano, MD
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A Health Care Management Company's Experience With Palivizumab -- 1 Year Later
William Silverman, MD, FAAP
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Management of Moderate to Severe Plaque Psoriasis with Biologic Therapy
David M. Pariser, MD
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Economic Analysis of Oral and Topical Therapies for Onychomycosis of the the Toenails and Fingernails
Julian Casciano, Karine Amaya, PhD, John Doyle, MPH, Steve Arikian, MD, Neil Shear, MD, Marc Haspel, DPM
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The Quandary of Compounding for MCOs: Administrative Costs, Risks, and Waste
Thomas Kaye, RPh, MBA
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Measuring Efficiency of Physician Practices Using Data Envelopment Analysis
Steven Andes, PhD, CPA, Lawrence M. Metzger, PhD, CPA, John Kralewski, PhD, David Gans, MSHA
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Is 34 Weeks an Acceptable Goal For a Complicated Singleton Pregnancy?
J. Stephen Jones, MD
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Examining Costs of Chronic Conditions In a Medicaid Population
Robert I. Garis, RPh, PhD, Kevin C. Farmer, PhD
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Diabetes Disease Management in a Community-Based Setting
Gregory D. Berg, PhD, Sandeep Wadhwa, MD, MBA
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Estimating Pediatric Primary Care Provider Visits In a Capitated Environment: Encounter vs. Claims Databases
Ernest P. Schloss
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The Effect of Practitioner Compensation on HMO Consumer Satisfaction
John F. Scoggins, PhD
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An In-Office Diagnostic Procedure To Detect Dermatophytes In a Nationwide Study of Onychomycosis Patients
David Pariser, MD, Carol Opper
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Reframing the Pharmaceutical Manufacturer/Health Plan Relationship in Managed Care
Ira Studin, PhD, MPH
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A Health Care Management Company's Experience with Palivizumab
William Silverman, MD, FAAP
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Telemedicine: Cost-Effective Management of High-Risk Pregnancy
John Morrison, MD
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Managed Care Trends in Statin Usage
Gary R. Bazalo, MS, MBA
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Memoranda of Understanding Between Medicaid MCOs and Public Health Departments
Susan J. Zahner, DrPH, RN
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Satisfaction and Patient Outcomes of a Telephone-Based Nurse Triage Service
Joan M. O'Connell, Ph.D., M.H.S., Jack L. Stanley, B.A., C. Lucy Malakar, M.A.
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Inter-Rater Reliability Testing For Utilization
Sue McQuillian, FSA
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A Critical Review of the Arguments for Insurance Coverage for Smoking-Cessation Therapies
Cyril F. Chang, Ph.D.
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Persistence With Drug Therapy: A Practical Approach Using Administrative Claims Data
Christopher M. Dezii, R.N., M.B.A.
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Medical Savings Accounts
Robert A. Connor, Ph.D., M.H.A.
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An Evidence-Based Evaluation of Percutaneous Vertebroplasty
Susan A. Levine, D.V.M., Ph.D., Lawrence A. Perin, M.D., M.B.A., Diane Hayes, Ph.D., Winifred S. Hayes, Ph.D.
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