Research Roundup: ACOs; Diabetes; Food Allergies; And Medicaid

Commonwealth Fund: How ACOs Are Caring For People With Complex Needs
With an incentive to provide high-quality care while controlling costs, accountable care organizations (ACOs) may focus on patients who require the most resources and are most at risk for encountering serious problems with their care. Understanding how ACOs approach care for complex patients requires examination of their organizational strategies, contracting details, and leadership structures. (Peck, 12/11)

JAMA Internal Medicine: Assessment Of Self-Monitoring Of Blood Glucose In Individuals With Type 2 Diabetes Not Using Insulin
Low-value care worsens patient-centered outcomes and imparts a negative economic effect, which has prompted the Choosing Wisely campaign to promote a national dialogue on the judicious use of services that are deemed to be nonbeneficial. One recommendation is “avoid routine multiple daily self-glucose monitoring in adults with stable type 2 diabetes on agents that do not cause hypoglycemia.” (Platt et al, 12/10)

Pediatrics: The Public Health Impact Of Parent-Reported Childhood Food Allergies In The United States
Childhood food allergy (FA) is a life-threatening chronic condition that substantially impairs quality of life. This large, population-based survey estimates childhood FA prevalence and severity of all major allergenic foods. Detailed allergen-specific information was also collected regarding FA management and health care use. (Gupta et al, 12/1)

Commonwealth Fund: Evaluations Of Medicaid 1115 Demonstrations Restrict Eligibility
With thousands in Arkansas losing their Medicaid benefits under the state’s work-requirement demonstration, the importance of evaluating such experiments could not be clearer. In Stewart v. Azar, the court concluded that the purpose of Section 1115 demonstrations such as Arkansas’s is to promote Medicaid’s objective of insuring the poor; evaluations of these demonstrations, as required by law, inform policymakers whether this objective is being achieved. (Rosenbaum et al, 12/12)

Pediatrics: The Prevalence Of Parent-Reported Autism Spectrum Disorder Among US Children
Parents of an estimated 1.5 million US children aged 3 to 17 years (2.50%) reported that their child had ever received an ASD diagnosis and currently had the condition. Children with parent-reported ASD diagnosis were more likely to have greater health care needs and difficulties accessing health care than children with other emotional or behavioral disorders (attention-deficit/hyperactivity disorder, anxiety, behavioral or conduct problems, depression, developmental delay, Down syndrome, intellectual disability, learning disability, Tourette syndrome) and children without these conditions. (Kogan et al, 12/1)

Health Affairs: The Use Of Telemedicine By Physicians: Still The Exception Rather Than The Rule
Using data from the American Medical Association’s 2016 Physician Practice Benchmark Survey, we provide the first nationally representative estimates of physicians’ use of telemedicine. In 2016, 15.4 percent of physicians worked in practices that used telemedicine for a wide spectrum of patient interactions, including e-visits as well as diagnoses made by radiologists who used telemedicine to store and forward data. In the same year, 11.2 percent of physicians worked in practices that used telemedicine for interactions between physicians and health care professionals. We found that in addition to specialty, larger practice size was an important correlate of telemedicine use. This suggests that despite regulatory and legislative changes to encourage the use of telemedicine, the financial burden of implementing it may be a continuing barrier for small practices. (Kane and Gillis, 12/3)