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Background: Type 2 diabetes mellitus (T2D) remains a pressing public health concern. Despite advancements in antidiabetic medications, suboptimal medication adherence persists among many individuals with T2D, often due to the high cost of medications. To combat this issue, Blue Cross and Blue Shield of Louisiana (Blue Cross) introduced the $0 Drug Copay (ZDC) program, providing $0 copays for select drugs. This study sought to explore barriers and facilitators to the successful implementation of Blue Cross's ZDC program (updated version)., Methods: Focus group discussions and interviews were conducted with health plan leadership, health coaches and providers who participate in the health plan organization's healthcare quality improvement program. Focus group discussions and semi-structured interviews were conducted between October 2022 and July 2023. Discussion guides were developed collaboratively and tailored to each participant group. Interviews were recorded, transcribed and analysed using NVivo ® qualitative analysis software. A descriptive, qualitative analysis was conducted, resulting in the identification of seven codes and subsequent candidate themes., Results: In total, 15 participants were interviewed: 6 were Blue Cross administrators, 5 were health coaches and 4 were Quality Blue providers. Overall, participants had positive feedback on the ZDC program and perceived that it has significant benefits for patients and the health system but could be improved, and four themes related to implementation barriers and facilitators, effectiveness and potential areas of improvement were identified: (1) the ZDC program reduces friction for patients, prescribers and the health system; (2) the program is aligned with the values of health systems, insurers and providers, facilitating implementation success; (3) expanding coverage (drug classes and conditions) and education (for providers and patients) could maximize program benefits; and (4) coronavirus disease 2019 (COVID-19) did not negatively impact program administration because the $0 copay was programmed at the benefit level., Conclusions: The ZDC program aligns goals and can benefit patients, providers and patients. The program can have the largest potential if it is expanded to include new medications and new conditions, and if there is more education for patients and providers. Regardless of challenges, reduced-copay programs have the potential to improve medication adherence, improve HbA1C control and improve overall health outcomes. Trial Registration This study was approved by the Tulane University Institutional Review Board, IRB #2020-1986., Competing Interests: Declarations. Ethics approval and consent to participate: This study was approved by the Tulane University Institutional Review Board, IRB #2020-1986. Informed consent was obtained from all individuals participating in interviews or focus groups. Participants were provided with detailed information about the study and gave their consent for their responses to be used for research purposes. All identifying information was anonymized to protect participant privacy. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

A growing body of research has identified teacher residency's potentials for improving and sustaining preservice teacher learning through a stronger district–university partnership. Drawing on sensemaking perspectives on education policy implementation, this qualitative case study examines how a variety of university and district stakeholders make sense of and implement a state-mandated teacher residency in Louisiana. Findings reveal that stakeholders are primarily making sense of the residency in isolation, leading to incoherent understandings and varied implementation practices. Opportunities to improve stakeholders' collective sensemaking and collaborative implementation and to optimize the benefits and potentials of teacher residency partnerships are discussed. This study has implications for teacher education policy implementation and continuous inquiry into the complexities of teacher preparation. [ABSTRACT FROM AUTHOR]

Phase III of the Louisiana School Effectiveness Study (LSES-III) was designed to provide rich, qualitative and quantitative data on the characteristics of more and less effective schools. Data were gathered on eight matched outlier pairs of schools. Unbeknownst to the authors at the beginning of LSES-III, four of the eight historically ineffective schools were engaged in school improvement efforts. None of these efforts was guided from the state or district. This serendipity provided an opportunity to observe improvement efforts which were of the ‘naturally occurring’ — as opposed to externally developed, mandated or otherwise offered — variety. The four projects are described, complete with five year follow-up data. The efforts are seen as falling along two dimensions: technical changes designed to raise achievement test scores; and efforts focused on a point along a continuum ranging from orderliness to excellence, and designed to raise students' academic achievement. Comparisons are made to more formally planned school improvement efforts. [ABSTRACT FROM AUTHOR]

Blue Cross Blue Shield of Louisiana (Blue Cross)'s Zero Dollar Copay (ZDC) program removes the copay for a large set of medications related to certain chronic diseases. All study participants were taking ZDC program-related drugs during the study period with at least 1 month of claims following ZDC enrollment. [Extracted from the article]