Insurance

Patients who received a diagnosis of small cell lung cancer (SCLC) between 2010 and 2016 had a nearly 2% increase in overall survival vs those who received their diagnosis between 2004 and 2010.

Most patients taking a biologic stayed on the therapy, and most saw decreases in exacerbations, a new study has found.

Imposing a surcharge on unvaccinated employees will require employers to think through legal and policy implications.

As part of the Biosimilars Initiative, British Columbia, Canada, implemented a mandatory switch to biosimilar insulin glargine for patients covered by the province’s drug plan.

Veterans residing in rural areas were less likely to complete annual repeat lung cancer screenings compared with those living in a nonrural location, with reduced uptake of initial lung cancer screening also found among eligible veterans in rural vs nonrural locations.

COVID-19–related hospitalizations are up 17% week over week; an estimated 5 to 14 million Americans could lose their Medicaid coverage this year or next year; the CDC is investigating unexplained cases of severe hepatitis in children.

UPMC Health Plan, RxAnte, and Mosaic Pharmacy Services outlined how they are operating a value-based pharmacy care management program within Community HealthChoices, Pennsylvania’s managed Medicaid long-term services and supports (LTSS) program, at a recent conference.

Using socioeconomic status (SES) as their primary exposure, investigators from McGill University, University of Manitoba, Institut National de Santé Publique du Québec, and Laval University investigated reasons behind insulin pump uptake disparities in the Canadian provinces of Manitoba and Québec.

Elaine Siegfried, MD, professor of pediatrics and dermatology, Saint Louis University Health Sciences Center, discusses several pediatric patient populations with atopic dermatitis who are candidates for the use of systemic therapies.

This article presents findings from interviews conducted with executives from 29 Medicare Advantage plans regarding plan decision-making processes related to new social risk factor–related benefits.

Without addressing rising costs, the problem of underinsurance in health care coverage will remain, said panelists at the 2022 V-BID Summit, discussing some of the smaller steps that are being proposed or are already in place to try to ease the financial burden.

Despite their intention to protect against coverage denial and/or premium increases, additional state-level Medigap regulations are correlated with lower Medigap enrollment and stronger moral hazard.

Jill Hutt, vice president of member services at the Greater Philadelphia Business Coalition on Health (GPBCH), outlines how Wilmington, Delaware, went about implementing the Diabetes Prevention Program.

A new lawsuit aims to block a $13 billion health insurance acquisition; the CDC is expected to release updated mask guidelines; the European Medicines Agency supports boosters among teenagers for COVID-19.

Speaking during a webinar presented by the National Alliance of Healthcare Purchaser Coalitions, experts weighed the pros and cons of employer high-deductible health plans (HDHPs) and outlined steps to address challenges raised.

Opioid utilization management in Medicare was associated with mixed effects on opioid prescribing, and prior authorization was associated with a decreased likelihood of subsequent overdose.

Medicaid managed care utilization review data for mental health services were analyzed for the calendar years 2017 and 2018. These data indicate low rates of utilization review denials for both inpatient and outpatient mental health services.

The rise in popularity of genetic testing brings along a myriad of challenges ranging from concerns on data privacy to insurance coverage, but, when utilized correctly, it could mark a step forward for significant advancements in individual and population health.

Geoffrey Boyce, CEO of Array Behavioral Care, discusses Array AtHome’s telebehavioral health services, which are now available to approximately 5 million Humana Medicare Advantage members.

In the newly-updated booklet, The Myth of Average: Why Individual Patient Differences Matter, the National Pharmaceutical Council (NPC) explores the barriers patients face when navigating the health care system and identifies opportunities for health care decision-makers to build better health care benefits and improve patient access to needed treatments.

The deadline to enroll in health insurance available through the Affordable Care Act on the federal exchange is Saturday, January 15.

CMS proposed rulemaking Thursday that would pass pharmaceutical price concessions to beneficiaries in Medicare Part D plans and make the medical loss ratio in Medicare Advantage plans more robust.

On this episode of Managed Care Cast, we bring you part 1 of an 8-part video conversation with Blue Cross Blue Shield of North Carolina and Newton Family Physicians about how they adapted to deliver health care in 2020 and 2021.

This 8-part conversation with Blue Cross and Blue Shield of North Carolina and Newton Family Physicians, moderated by The American Journal of Managed Care® (AJMC®), focuses on the role of value-based care, independent care practices, and other aspects of health care that have been and continue to be affected by the continuing COVID-19 pandemic, even as we enter 2022. This is part 8.

This 8-part conversation with Blue Cross and Blue Shield of North Carolina and Newton Family Physicians, moderated by The American Journal of Managed Care® (AJMC®), focuses on the role of value-based care, independent care practices, and other aspects of health care that have been and continue to be affected by the continuing COVID-19 pandemic, even as we enter 2022. This is part 5.

This 8-part conversation with Blue Cross and Blue Shield of North Carolina and Newton Family Physicians, moderated by The American Journal of Managed Care® (AJMC®), focuses on the role of value-based care, independent care practices, and other aspects of health care that have been and continue to be affected by the continuing COVID-19 pandemic, even as we enter 2022. This is part 5.

This 8-part conversation with Blue Cross and Blue Shield of North Carolina and Newton Family Physicians, moderated by The American Journal of Managed Care® (AJMC®), focuses on the role of value-based care, independent care practices, and other aspects of health care that have been and continue to be affected by the continuing COVID-19 pandemic, even as we enter 2022. This is part 4.

This 8-part conversation with Blue Cross and Blue Shield of North Carolina and Newton Family Physicians, moderated by The American Journal of Managed Care® (AJMC®), focuses on the role of value-based care, independent care practices, and other aspects of health care that have been and continue to be affected by the continuing COVID-19 pandemic, even as we enter 2022. This is part 3.