Christina Mattina

A recent study in Health Affairs indicated that insurers with greater market shares are better able to negotiate lower prices, particularly from larger provider groups. The findings could have far-reaching implications as insurers continue to merge and smaller provider groups face lower payments.

The impending repeal of Obamacare has sparked concerns that vulnerable groups will lose insurance coverage and access to treatment, including HIV/AIDS patients.

These guidelines provide an overview of the current recommendations surrounding HIV/AIDS diagnosis, treatment, and complications.

Payments for catastrophic coverage under Medicare Part D have more than tripled since 2010, rising past $33 billion in 2015, according to a new report from the Office of Inspector General (OIG). The report identified high-priced specialty drugs as a major driver of the increase in spending.

In a letter to CMS, the National Association of Medicaid Directors contended that a 15-day limit on inpatient psychiatric treatment reimbursement is too short for effective treatment of some patients diagnosed with severe mental illness or substance use disorder.

More hospitals are switching to employment-based affiliations with physicians, but a recent analysis found no association between conversion to an employment model and changes in mortality, readmissions, length of stay, or patient satisfaction rates.

A survey of young adults revealed that those with arthritis reported significantly higher rates of employment and lower rates of education participation than their peers without arthritis.

Research on the role of community health workers shows that they can help patients manage their hypertension, in part by addressing barriers to medication adherence.

As 2016 drew to a close, The American Journal of Managed Care (AJMC)® polled readers on what was, in their opinion, the biggest healthcare story of the year. Runners-up included drug pricing drama, Medicare policy announcements, and more, but the top answer by far was the news story that sent shockwaves throughout the healthcare industry and around the world.

Contributors to AJMC.com bring fresh insight from their real-world experiences to discuss important subjects in managed care, which this year included topics like accountable care organizations, telehealth, and urgent care prescribing. Here are the 5 most-read articles from our contributors in 2016.

After the passage of the Affordable Care Act in 2010, hospital readmission rates decreased nationwide, most dramatically for the lowest-performing hospitals, according to an analysis of readmissions data published in the Annals of Internal Medicine.

This year, The American Journal of Managed Care® (AJMC®) published peer-reviewed research on a multitude of managed care topics, including benefit design, health information technology, and clinical pathways.

Gift-givers have more options than ever when choosing the perfect toy for a child with special needs, thanks to advocacy efforts in recent years to make toy stores more inclusive.

A study that purported to doubt on the scientific evidence supporting current sugar intake guidelines has been criticized for its funding source: the sugar, food, and beverage industries.

A report card published by the National Organization for Rare Disorders issued grades to each state for 7 categories of rare disease policies.

A study by The Commonwealth Fund reports that uninsured rates have dropped in all states and fewer patients in most states say cost is a barrier to care. These improvements were observed in the years after the implementation of the Affordable Care Act.

This year, the most read articles from The American Journal of Accountable Care® explored how healthcare providers and payers have implemented innovative ideas to reduce spending while maintaining or increasing the quality of care.

A case study of an innovative model for wound care suggested that an integrated approach to healing wounds could result in decreased costs of care and length of hospital stay.

Research published in JAMA indicates that the proportion of pregnant women who have recently used marijuana has increased significantly from 2002 to 2014.

A recent study that conducted interviews with mainly Latino residents of agricultural communities in California found that most considered affordability, not access, a major barrier to buying healthy foods.

A study on gender and racial inequalities in the prevalence of chronic obstructive pulmonary disease among non-smokers found that black Americans and women are at higher risk, possibly due to a combination of biological and social factors.

After widespread criticism from healthcare providers, drug companies, and lawmakers, CMS has announced that it will not go forward with its proposed Medicare Part B payment program. The experimental reimbursement model was intended to reduce outpatient drug spending, but oncologists worried it would have unfairly slashed their Part B payments.

A new accountable care organization (ACO) model announced by CMS aims to improve care and lower costs by allowing beneficiaries enrolled in both Medicare and Medicaid to be covered under a Medicare Shared Savings Program ACO.

A longitudinal 5-year study that tracked women seeking abortions found that women who were turned away had worse mental health outcomes than those who received an abortion, contrary to some claims that abortion can have long-lasting psychological consequences.

The Department of Veterans Affairs healthcare system has announced a final rule that will grant full practicing authority to some types of advanced practice registered nurses, with the exception of nurse anesthetists.

As the healthcare industry continues its transition toward value-based care, some medical ethicists have raised concerns about how education with an emphasis on value can potentially conflict with patients’ best interests. An opinion letter published in JAMA discusses various strategies for addressing these tensions.

An analysis of Medicaid coverage for substance abuse treatments revealed that the services and medications covered vary widely by state. The Health Affairs study raised concerns that patients in some states may not have adequate access to necessary addiction treatment.

The United States is in the midst of an opioid epidemic that has been responsible for a 200% increase in deaths due to overdose of heroin or an opioid pain reliever since 2000. Guidelines provide clinicians with ways to identify patients at risk of opioid use disorder and best practices of prescribing opioids.

The CDC’s National Center for Health Statistics released a report with new data on the 2015 US mortality rates. Here are 5 findings to take away from the report.

At the 2016 San Antonio Breast Cancer Symposium, researchers announced the creation of a model to identify patients with triple negative breast cancer who are most likely to respond to chemotherapy.