Highlights of coverage of our peer-reviewed research in the healthcare and mainstream press.
The new study in The American Journal of Managed Care, “Effects of Physician Payment Reform on Provision of Home Dialysis,” received extensive coverage this week. Researchers led by Kevin F. Erickson, MD, MS, examined patterns of care after a change in Medicare payment rules for home-based dialysis. The study found that patients in traditional Medicare were 1% less likely to have home-based dialysis after a change that increased payments for in-center dialysis for patients with end-stage renal disease. As Jacqueline Belliveau wrote in RevenueCycle Intelligence, financial incentives were a significant factor in deciding where patients would be treated. Making in-center dialysis more lucrative could work against patient quality of life, because some dialysis patients have mobility issues or problems finding transportation. Emily Rappleye, writing for Becker’s Hospital Review, noted that the patients most affected were those living near large dialysis facilities. She quoted the authors: “These findings highlight both an area of policy failure and the importance of considering unintended consequences of future efforts to reform physician payment.”
CMS released a final rule to help patients obtain Children’s Health Insurance Program (CHIP) coverage and issued a proposed rule to update Medicare payment policies and rates for inpatient rehabilitation facilities; debate over if gift card incentives are acceptable in health care marketing.
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Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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A global AIDS program that was in limbo for months got temporary relief after congressional negotiators agreed to a 1-year renewal in the next government funding package; the outcome of the November presidential election could determine the state of fetal tissue research in the US; federal officials and industry executives failed to make improvements that stop hacking attacks.
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Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
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Fragmented Payer System, Vulnerable Supply Chain Among Threats to Accessing Essential Medicines
March 13th 2024During a session of the 2024 V-BID Summit, panelists Stacie Dusetzina, PhD, and Inma Hernandez, PharmD, PhD, discussed how access to essential medications is curtailed not just by the longstanding complexities of insurance design but also by emerging threats such as supply chain weaknesses and cyberattacks.
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Most private health insurers have yet to publish criteria for when they will cover postpartum depression drug, zuranolone; state lawmakers are increasingly opposing health care mergers that they believe do not serve the public interest; Medicaid extensions made in 2021 led to a 40% decline in postpartum lack of insurance.
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