Laura Joszt, MA

Panelists discussed low-value care, unnecessary services, and what can be done to address overuse in healthcare during a panel at the University of Michigan Center for Value-Based Insurance Design’s (V-BID) annual V-BID Summit on March 14.

Patients with acute myeloid leukemia (AML) who were treated at a National Cancer Institute-designated cancer center had a 53% lower risk of early mortality, according to a study published in Cancer.

Panelists Kavita Patel, MD, Brookings Institute; Michael E. Chernew, PhD, Harvard Medical School; and Katy Spangler, Spangler Strategies discussed implementing the value-based insurance design concept in health policy and payment models, challenges with quality measurements, the role of employers in value-based care, and more at the VBID Summit, held March 14 by the University of Michigan Center for Value-Based Insurance Design.

Rural counties in the United States have experienced a decline in the availability of hospital-based obstetric services, dropping from 55% of counties having these services in 2004 to 46% in 2014. This loss can “exacerbate maternal health challenges” in rural areas, according to a study in JAMA.

As hospitals are increasingly held accountable for what happens outside the hospital walls, they need access to better claims data. In a recent study published in the November issue of The American Journal of Managed Care®, researchers with the Michigan Value Collaborative found that it is possible to derive episode-level utilization from claims data and it provides a level of postdischarge care precision that is superior to medical records that hospitals have access to.

Idaho tested the Trump administration's willingness to provide flexibility to states on the health insurance options they offer. CMS has ruled that Idaho cannot sell health plans that do not meet the requirements of the Affordable Care Act (ACA).

Elected officials and others who affect policy know that cost-sharing and out-of-pocket costs are issues in healthcare, but they don’t truly understand the issues, said panelists during a policy discussion on ways to improve access and reduce financial hardship during the Cost-Sharing Roundtable.

Patients with chronic obstructive pulmonary disease (COPD) who were trained on appropriate inhaler use and who were checked on their use were significantly more likely to be adherent, study found.

The first results of the Oncology Care Model (OCM), a 5-year bundled payment demonstration from CMS, were released recently, and at a session at the National Community Oncology Dispensing Association Spring Forum 2018, Mike Fazio of Archway Health discussed the reconciliation statements from the first performance period of OCM, and where practices can look to make improvements going forward.

As cancer treatments improve and death rates decline, more patients survive who are at risk of becoming addicted to pain medications they were prescribed to treat their cancer-related pain, explained Merrill Norton, PharmD, NCAC II, CCS, CCDP-D, of the University of Georgia.

Positive quality interventions are part of a nationwide effort to standardize and improve oncology dispensing practices. They are best practices that are meant to be highly specific to a drug and help pharmacies and clinicians ensure that a patient-centric model exists, explained speakers during a workshop at National Community Oncology Dispensing Association (NCODA) Spring Forum 2018.

Being proactive about identifying potential financial burdens and preparing patients who have a disease for the costs of their treatment helps to ensure that patients will be adherent to their medication and have the best possible outcomes, according to a panel of providers at the Cost-Sharing Roundtable, co-hosted by the Patient Access Network Foundation and The American Journal of Managed Care®.

Coverage from the National Community Oncology Dispensing Association Spring Forum 2018.

Since 2000, the number of patients undergoing gender-affirming surgery who identified as self-payers decreased. From 2012-2013 to 2014, coverage by Medicare and Medicaid of gender-affirming surgeries increased 3-fold.

State variations in chronic obstructive pulmonary disease (COPD) outcomes suggest that the condition is more common in large rural areas compared with metropolitan areas, according to the Morbidity and Mortality Weekly Report from CDC.

New research has found that allogeneic hematopoietic stem cell transplantation is just as effective in patients with non-Hodgkin lymphoma who are age 65 and older as it is in patients between the ages of 55 and 64.

Clinical and policy decisions made using early trial results could be misguided, according to a study that found early results in chronic disease trials are often exaggerated compared with findings in subsequent trials.

Patients with chronic myeloid leukemia (CML) who have a sustained deep molecular response can maintain treatment-free remission for at least 48 weeks after using second-line nilotinib, according to a new study published in Annals of Internal Medicine.

Long-term use of inhaled corticosteroids, which are widely used to treat chronic obstructive pulmonary disease, are associated with an increased risk of fractures, according to a new study in CHEST.

A new National Bureau of Economic Research working paper identified potential hospital cost shifting and that hospitals penalized by the Hospital Readmission Reduction Program and the Hospital Value-Based Purchasing Program actually had an increase in average payments of 1.5%.

In a new letter published in the February issue of The American Journal of Managed Care®, Martin Makary, MD, a professor of surgery at Johns Hopkins University, and his coauthors assessed price markup variation by hospital and by oncology specialty to better understand the financial hardships patients can face when charges for the same service vary widely across hospitals.

New research published in The Lancet Oncology found that denosumab was noninferior to zoledronic acid for time to skeletal-related events in patients with newly diagnosed multiple myeloma.

FDA has approved apalutamide, the first treatment for nonmetastatic castration-resistant prostate cancer, based on results from a phase 3 study that showed the drug reduced the risk of metastasis or death by 72% and improved median metastasis-free survival by more than 2 years.

A new study found that patients with chronic obstructive pulmonary disease with higher symptom burden are worse at self-management, which is an important part of managing the disease.

The addition of daratumumab to standard-of-care regimens used to treat multiple myeloma, such as bortezomib, melphalan, and prednisone, decreased the risk of disease progression or death in newly diagnosed patients who were ineligible for autologous stem-cell transplantation.

Multimorbidity is common in patients with chronic obstructive pulmonary disease (COPD), and is associated with high levels of polypharmacy, which can lead to an increased risk of adverse drug reactions.

After a brief shutdown in the dead of night, the Senate passed a spending bill, which was the result of a deal reached by Republicans and Democrats to fund military and domestic programs for 2 years. The House passed the bill shortly after.

A long-term follow-up analyzing the toxic effects and results from a phase 1 clinical trial of adult patients with relapsed B-cell acute lymphoblastic leukemia (ALL) who were treated with CD19-specific chimeric antigen receptor (CAR) T cells found patients with low disease burden had a longer medial overall survival and a lower incidence of toxicity.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

Replacing the Merit-based Incentive Payment System (MIPS) with a voluntary program should encourage providers to move quicker into more risk-based payment models, according to Travis Broome, vice president for policy at Aledade.