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This analysis demonstrates how Medicare Advantage (MA) supplemental benefits can improve healthcare utilization and outcomes. It used a rigorous methodology to isolate the added value of supplemental benefit use. The findings link supplemental benefit use to a decreased likelihood of inpatient admissions and unnecessary emergency department visits, as well as an increased likelihood of outpatient visits and preventive screenings.

Elevance Health’s affiliated Medicaid managed care plan in West Virginia is making a difference for consumers with opioid use disorder (OUD) by integrating behavioral and physical healthcare. As highlighted in this report, the plan effectively reduced overdoses by 33%, self-harm incidences by 62%, and neonatal abstinence syndrome (NAS) rates by 82% between July 2019 and April 2023.

Patients of doctors who treat racially and ethnically diverse patient bases are more likely to be up to date with their colorectal cancer screenings, according to this analysis. The research suggests that working with and understanding diverse patients is important to help doctors address healthcare inequities.

This paper highlights how Elevance Health is helping improve housing stability for families experiencing or at risk for homelessness. Results from an affiliated health plan in Nevada show that 90% of consumers who received a housing intervention maintained stable housing six months post-intervention. These results suggest such interventions could help make housing stability more equitable.

This article, from NEJM Catalyst, highlights common challenges and opportunities to improve patient safety in value-based care (VBC) arrangements. The authors propose strategies to help payers integrate patient safety measures into VBC contracts and align financial incentives with quality performance. They point to an initiative from Elevance Health as an example of successful implementation of that strategy.

In this Fast Company article, Carelon Health President Bryony Winn discusses why value-based care must remain a permanent part of our national healthcare system. “Value-based care (VBC) works, and while it should continue to evolve, it is here to stay,” she writes.

Doula programs can improve outcomes for women at a higher risk of maternal morbidity, according to this report. The analysis uses data from nine Elevance Health-affiliated Medicaid plans to compare outcomes among women with and without doula care. Women with a doula experienced comparatively better outcomes, including a lower prevalence of C-sections and a higher prevalence of postpartum visits. The report goes on to cover considerations to help states successfully implement a doula benefit in their Medicaid programs.

This article, from the American Journal for Public Health, highlights the benefits of doula care, showing that it has been associated with better outcomes for Medicaid members. It also examines the impact of doula care on maternal health disparities and offers pivotal insights into strategies policymakers should consider to address maternal health in the U.S.

This report underscores the critical role that the timing of Medicaid enrollment can play in shaping birth outcomes. It analyzes data from 19 Elevance Health-affiliated Medicaid plans to compare outcomes related to enrollment timing during pregnancy. Women who enrolled later in pregnancy seemed healthier while pregnant but experienced higher risks of mortality post-delivery compared to women who enrolled in their first trimester.

The authors of this study looked at commercial longitudinal data to try to determine whether prior authorization factors into racial and ethnic disparities in cancer care. They found no difference in the prior authorization process for Black, Hispanic, and White patients. However, they noted that Asian patients typically had lower denial rates than White patients. More research is needed to understand these patterns and what they mean.

This observational study compares C-section outcomes with vaginal birth outcomes to better understand the risks of C-sections for mothers and babies. The research suggests that adverse outcomes were more prevalent for those births than for vaginal births.

A collaboration between Elevance Health and a network of independent community pharmacies demonstrated improved outcomes for Iowa Medicaid consumers who engaged with the program to manage their complex or chronic conditions. Engagement was also associated with a favorable change in medical services utilization and a reduction in medical costs.

This study from The University of Chicago Press Journals examines what happens when health systems acquire independent hospitals, specifically as it relates to the cost and quality of care. It suggests that these acquisitions do not improve care quality and might even cause it to decline. Additionally, such acquisitions can cause negotiated inpatient prices to increase, especially if the target and acquirer are in the same market and the acquired hospitals get large operating-cost benefits.

This analysis from the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) looks at the costs associated with schizophrenia and schizoaffective disorder. It highlights the heavy toll of the conditions, particularly when patients experience relapses in symptoms. The research shows that healthcare resource utilization rose for the patient population with each relapse.