State Oncology Societies Join ASCO's Call on Congress to Replace SGR Formula
In a show of solidarity, state oncology societies from across the United States today joined the American Society of Clinical Oncology in its call on Congress to repeal Medicare's Sustainable Growth Rate formula before the current payment patch expires at the end of the month.
Access to Low-Cost Sovaldi: Pharmacy Tourism
The global price discrimination with Sovaldi has brought to light "pharmacy tourism" - patients trying to acquire the same drug at as much as 1% of the price of the drug in the US market.
Forcing Leukemia Cells to Behave
During laboratory experiments, while growing these leukemic cells, the authors observed that some of the cancer cells in culture were changing shape and size into what looked like macrophages. Subsequent experiments confirmed that by manipulating some of the transcription factors, these human cancer cells could be transformed into macrophages, which can engulf and digest cancer cells and pathogens.
Medicaid Expansion Improved Diabetes Detection, Study Finds
The study, conducted by the national laboratory Quest Diagnostics, found that in states that expanded Medicaid, he number of Medicaid enrollees with newly identified diabetes rose by 23%, to 18,020 in the first 6 months of 2014, from 14,625 in the same period in 2013.
Workplace Insurance Enrollment Unaffected by the ACA
There has been much hand wringing over the health law requirement that large employers this year offer insurance to workers who put in 30 or more hours a week or face penalties for not doing so. A new study found that so far there’s little cause for concern.
Seeking Funding for the Children’s Health Insurance Program
The federal-state Children’s Health Insurance Program will run out of money on September 30. Until recently, Congress showed little interest in paying for it. But this week, the House agreed on a bill that would continue the $13 billion program in its current form through 2017.
Healthcare Reform's Impact on Employer-Sponsored Insurance
The federal and state health insurance exchanges, while generating a great amount of attention and controversy, still only represent a small fraction of the marketplace.
HHS Recovered $3.3 Billion in Fraudulent Healthcare Payments in 2014
More than $3 billion was returned to the Medicare Trust Fund in 2014 from individuals and companies attempting to defraud federal health programs, according to an announcement by HHS.
Biogen's Alzheimer’s Drug Sharply Slows Cognitive Decline
An experimental drug for Alzheimer’s disease sharply slowed the decline in mental function in a small clinical trial, researchers reported Friday, reviving hopes for an approach to therapy that until now has experienced repeated failures.
60% of Medicare Advantage Enrollees in Plans with 4 or More Stars
New analysis from Avalere finds that the proportion of Medicare Advantage beneficiaries enrolled in plans with 4 or more stars climbed from 38% in 2014 to 60% in 2015.
SGR Fix Bills Include Proposed Health IT Changes
A bipartisan coalition in the House and Senate introduced identical bills that repeal Medicare's notorious formula for setting physician pay and, have implications for health information technology.
Managed Care Minute: March 21, 2015
A one-minute look at managed care news during the week of March 16, 2015, including bills from Congress to fix the sustainable growth rate formula and anticipation over the PCSK9 inhibitors.
Stage 3 Meaningful Use Rules Include More Flexibility, Drive Interoperability
CMS released its proposed rules for Stage 3 meaningful use for the Medicare and Medicaid Electronic Health Records Incentive Programs. The proposed rules will include greater flexibility and drive interoperability, according to HHS.
Oregon's Medicaid Lottery Works, Says MIT Economist
By using a lottery to assign coverage, Oregon had unintentionally created the perfect conditions for a randomized controlled trial that could reveal the true costs and benefits of health insurance.
Myriad to Present Prolaris Results at EAU Congress
The company said results from a study of European men are consistent with prior studies of men with early prostate cancer that were conducted in the United States.
Expanding the Reach of mHealth Among Low-Income Populations
The study, conducted by Elissa Ozanne, PhD, at Dartmouth found that 11 of the 15 women, aged 45-79 years, interviewed before and after using the mHealth tool preferred it to a paper tool and found it easy to use.
Novartis/Sandoz Clear to Market Their Biosimilar Zarxio
Zarxio was approved earlier this month, the first biosimilar to be approved in the United States.
Enrollees on the Exchanges Fill More and Costlier Prescriptions
Patients enrolled in plans on the public health insurance exchange filled more prescriptions than commercial members during the first year of enrollment under Affordable Care Act, according to a report from Prime Therapeutics.
Physicians Look for Support to Implement New Payment Models
Physician practices looking to engage in new healthcare payment models reported they need help and guidance to further advance delivery reforms, according to a joint study from the RAND Corporation and the American Medical Association.
COA Supports Bipartisan Bill to Prevent Medicare Sequestration Cuts in Oncology
"It's so ironic that CMMI, the innovation arm of CMS, is trying to sell us on implementing a new payment model for oncology while community oncology practices are struggling financially to keep their doors open because of CMS payment cuts," said Ted Okon, executive director, Community Oncology Alliance.
House, Senate Introduce Bills to Fix SGR
The agreement would put an end to 17 straight fixes to the sustainable growth rate that have not found a permanent solution for addressing the Medicare cost cuts envisioned in the original legislation.
UCLA Researchers Develop Program to Tackle Post-Chemo Cognitive Lapses
Training sessions with a psychologist, in women treated for breast cancer, helped women with their memory and to maintain their ability to pay attention to things—the so called "executive function and planning" activities.
Stakeholders Provide Insight on the Oncology Care Model
Payers, oncologists, and oncology policy experts provide their feedback on the Oncology Care Model developed by the Centers for Medicare and Medicaid Innovation, which aims to link payment to the quality of care, improve access to care, and enhance information sharing.
Coalition Looks at ACO Formation, Safer IT, and Healthcare of the Future
The ACO and Emerging Healthcare Delivery Coalition, an initiative of The American Journal of Managed Care, launched a little over a year ago to give stakeholders focused on accountable care opportunities to share ideas on how to move from volume- to value-based models. The Coalition’s most recent Web-based session shows how meetings have evolved to highly detailed discussions of how organizations are making those transitions.
Leading Healthcare Economists and Policy Experts Shed Light on Cancer Drug Costs
The paper, published in the latest issue of the Journal of Economic Perspectives, found that while drug price was related to quality improvement over existing therapies, the price increase surpassed quality.