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For the Basics, Retails Clinics Just as Good or Better Than Urgent Care or Emergency Rooms, Study Finds
With a shortage of primary care physicians and the costs that come with a trip to the emergency room, can retail clinics fill the gap? A study published today in The American Journal of Managed Care finds they can, offering care that is just as good or better for common ailments like ear infections or strep throat.
CMS Offers Upfront Investment to ACOs Through New Initiative
Accountable Care Organizations participating in the Medicare Shared Savings Program will have access to a new initiative that will support care coordination across the country, according to CMS. Up to $114 million in upfront investments will be made available.
ICD-10 Would Help US Better Track Ebola
If Congress had not pushed back the deadline for implementing ICD-10 last spring, the United States now would have a specific code for tracking Ebola, according to an infographic from the Coalition for ICD-10.
Medicare Advantage Star Ratings Increasing Overall Plan Quality
Quality in Medicare Advantage plans is increasing, and CMS credits the improvement to its star rating system. A growing number of Medicare enrollees are in plans receiving at least 4 out of 5 stars, according to a new fact sheet.
Exact Sciences' Cologuard Receives CMS National Coverage
The non-invasive nature of the test makes it a very attractive alternative to the uncomfortable colonoscopy used to detect colorectal cancer. In a New England Journal of Medicine study of 10,000 patients, the test identified 92% of colorectal cancers in average-risk patients and 42% of polyps.
After Roche, Celgene Faces Value Push-Back From NICE
After Roche saw 2 product rejects a few weeks back from NICE, based on a value argument, Celgene is in a similar boat with it's multiple myeloma drug pomalidomide.
A Look at Coverage Eligibility in Medicaid Nonexpansion States
In states that chose not to expand Medicaid eligibility under the Affordable Care Act, residents with a median income of less than $800 a month are now ineligible for coverage assistance while those with more than $2000 a month are eligible for subsidies, according to a report from the Urban Institute.
Blue Cross and Blue Shield of Illinois Pioneers First Specialty Intensive Medical Home Program
Blue Cross and Blue Shield of Illinois announces the first specialty intensive medical home program in the state, with the Illinois Gastroenterology Group, the state's largest independent gastroenterology practice, effective September 1, 2014.
Study Identifies Gender Bias in HPV Vaccination
Fewer than 15% of physicians routinely recommend HPV vaccination to male patients, according to the study published in the journal Cancer Epidemiology, Biomarkers & Prevention.
Few Organizations Have Infrastructure in Place to Handle Big Data
Although many providers are looking to implement cloud, big data, social, and mobile technologies within the next 2 years, if they haven't done so already, few healthcare organizations feel their infrastructures are prepared for this evolution of electronic medical records, according to a new study.
Obamacare Website Won’t Reveal Insurance Costs for 2015 Until After Election
Those planning to purchase health insurance on the Obamacare exchange will soon find out how much rates have increased—after the November 4 election.
Are EHRs to Blame in the Dallas Ebola Case?
That is the question that a Times commentary, penned by a physician, asks. With the enormous amount of data being collected and entered into EHRs, the human brain (in this case the physician brain) is probably tuning out information that would probably stay if there was a conversation with the patient instead.
ASCO Endorses CAP/IASLC/AMP Guideline on Molecular Testing for Lung Cancer
The American Society of Clinical Oncology has endorsed the joint guidelines established by the 3 Associations to help physicians make evidence-based decisions when selecting patients to administer some of the targeted therapies developed for lung cancer.
CMS Star Ratings’ Quality Bonus Payments Can Mean Survival for Health Plans
The quality bonus payments tied to CMS’ star ratings makes it critical that health plans receive a 4 or better, Jonathan Harding, MD, chief medical officer of the Senior Products Division at Tufts Health Plan, said at the America’s Health Insurance Plan’s National Conferences on Medicare and Medicaid, and Dual Eligibles Summit in Washington, DC, from September 28 to October 2.
Gilead's Harvoni Less Expensive, but Still a Burden on State Medicaid Programs
Gilead Sciences’ Harvoni represents the first once-a-day, complete treatment pill approved by the FDA to treat the hepatitis C virus (HCV). And for some patients, the drug will be less expensive than Gilead’s other HCV treatment, Sovaldi.
BMS' PD-1 Inhibitor, Nivolumab, to be Evaluated With Jansenn's Ibrutinib in NHL
Opdivo (nivolumab), which was approved in Japan in July 2014, is being globally developed for evaluation in non-small cell lung cancer (NSCLC), melanoma, renal cell carcinoma (RCC), head and neck cancer, glioblastoma, as well as NHL.
Priority Review for Pfizer's Palbociclib in Patients with Advanced Breast Cancer
The NDA submitted by Pfizer requests approval of palbociclib as a first-line therapy in combination with letrozole for ER+, HER2- advanced breast cancer.
Reference Pricing Programs Yield Only Modest Savings
Reference pricing programs can steer patients to lower-price, adequate quality providers, but potential savings to health plans and purchasers are actually modest, according to a study from the National Institute for Health Care Reform.
FQHC Success Vital to Health of Underserved Communities
With millions of new Medicaid beneficiaries, Federally Qualified Health Centers may not be able to keep up with the increased demand, even with access to federal funding.
ONC Report Acknowledges Interoperability Struggles, Barriers
Despite progress being made, health information technology interoperability remains a struggle, according to a report submitted by the Office of the National Coordinator for Health Information Technology and HHS to Congress.
Gilead's HCV Combo Pill, Harvoni, Convinces the FDA
While still being on the receiving end for the high cost of sofosbuvir, Gilead's combination pill for Hepatitis C (sofosbuvir + ledipasvir) was today approved by the FDA.
Insurers Lose $73M in Kansas in 6 Months Thanks to Medicaid
Medicaid expansion under the Affordable Care Act has been an overall success for insurers in most states that have implemented it; however, the story is different in Kansas, which switched its entire Medicaid program to a private model.
FDA Approves Akynzeo for Chemotherapy-Associated Nausea and Vomiting
The approval follows 2 clinical trials evaluating the regimen in 1720 cancer patients receiving chemotherapy.
Medicare Part B Premiums, Deductibles Unchanged for 2015
For the third year in a row, Medicare Part B monthly premiums and deductibles will remain unchanged at $104.90 and $147, respectively, according to HHS Secretary Sylvia Burwell.
Preparing for 10 Trends That Will Impact Managed Care Pharmacy
There are 10 emerging healthcare trends that will impact managed care pharmacy organizations over the next 5 years as the United States healthcare system places more emphasis on affordability, population health, and patient satisfaction and quality of care, according to a new report from the Academy of Managed Care Pharmacy.