Peer-Reviewed Articles from Managed Care
Research Articles from Managed Care
UM for outpatient discretionary echocardiography appeared to reduce testing rates significantly
Although this practice can optimize long-term patient outcomes, it is not routine in clinical practice
There was little difference between the options in terms of the frequency and cost of return visits. Patients receiving one-stage reconstructions returned slightly less often for breast-related services during the first 18 months after reconstruction, but the difference was not statistically significant.
Overweight or obese patients who participated in a medical nutrition therapy benefit sponsored through their insurer were compared with individuals who did not participate. Outcomes, including weight change, body mass index, waist circumference, and physical exercise, were collected at baseline and 2 years later.
Using case studies, researchers assess the effect of rebate rates on the cost-effectiveness of two oral bisphosphonates that are competing for tier 2 positioning
The researchers find that the costs of treating restless legs syndrome are fairly low, relative to the improved symptoms and associated health care outcomes, and are mainly attributable to prescription medication. Health plans are encouraged to expand coverage to reduce the associated suffering and costs.
Patients treated with oral linezolid, covered under the pharmacy benefit, had lower re-hospitalizations and emergency room visits than patients treated with vancomycin or daptomycin, covered under the medical benefit
This study verifies, as defined by current guidelines, that initial treatment with fixed dose combinations (FDC) is associated with a better likelihood of HbA1c goal attainment and lower health care resource use and costs.
A review of the available research identifies payment for services in the absence of high-quality scientific evidence and presents an opportunity to use evidence-based medicine to develop a clinical coverage guideline