Laura Joszt, MA

Approximately 70% of all Medicaid beneficiaries receive their healthcare services through managed care, and state Medicaid programs are required to report encounter data to a national database, but 8 states did not during fiscal year 2011, according to a new government report.

CMS has released additional guidance allowing for flexibility in claims auditing and quality reporting during the transition to the International Classification of Diseases, Tenth Revision and is working with the American Medical Association to educate providers.

Although the CDC expects death rates for most cancers to decrease by 2020, melanoma is the exception and new cases are expected to cost $1.6 billion in 2030.

Cardiovascular disease may be the leading cause of death in the United States, but half of those deaths can be prevented, according to researchers from Emory's Rollins School of Public Health.

The fact that a small percentage of the population accounts for roughly half of healthcare spending in the United States is not new information. Now a new white paper from the Health Care Transformation Task Force has taken a look at what healthcare systems can do to identify these individuals in order to better manage their care and lower spending.

Despite concerns that Medicare Advantage payment reductions included in the Affordable Care Act would lead to a decline in enrollment, the number and share of beneficiaries enrolling in Medicare Advantage has only continue to climb since the health reform law was enacted.

A week after JAMA released a report that found more than two-thirds of Americans age 25 years and older are overweight or obese, the American Academy of Pediatrics presented updated guidelines on preventing childhood obesity and recommendations for parents to help their children maintain a healthy weight.

Shortly after the Supreme Court ruled in favor of the government in King v. Burwell, President Barack Obama triumphantly claimed that "Affordable Care Act is here to stay." However, the truth is that GOP presidential hopefuls have no intention of letting the law stand.

Two new changes to CMS' ACO Investment Model will help practices in rural areas gain more access to the benefits of accountable care organizations.

With the Supreme Court ruling in King v. Burwell keeping subsidies available to consumers on the federally facilitated marketplace, healthcare associations, insurers, health plans, and other stakeholders have been voicing their support and relief at the 6-3 ruling.

Although Kentucky and Arkansas went about expanding Medicaid coverage in 2 different ways, they shared common strategies that led to their success.

The Supreme Court may have kept subsidies available to all Americans regardless of whether their state has set up its own exchange, but some people still refuse to purchase coverage, and they're perfectly happy remaining uninsured.

In a triumphant win for President Obama's Affordable Care Act and millions of Americans, the Supreme Court of the United States ruled against the plaintiffs in the case King v. Burwell and upheld the availability of subsidies for individuals on the federally facilitated marketplace.

A new study summarizing network size by physician, not just hospital participation, determined that 41% of networks on the marketplaces can be considered small or x-small and contain just 25% or less of office-based physicians in the area.

A more selective use of biomarker testing for patients with breast cancer could save millions of dollars without compromising the care they receive, according to the results of a study published in The American Journal of Surgical Pathology.

There have been numerous attempts to repeal part or all of the Affordable Care Act since it became law, and the Congressional Budget Office admits its estimates on the effect of repealing the law are all subject to "substantial uncertainty."

During the first year of health coverage expansion under the Affordable Care Act, many primary care providers said the number of patients they saw increased, but reported no compromise in quality of care provided, according to a study from the Kaiser Family Foundation and The Commonwealth Fund.

One of the most vocal physicians about the high prices of cancer drugs, Peter Bach, MD, MAPP, director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center, recently led the effort to create a value-based calculator to determine the true worth of cancer drugs.

Newly announced fraud charges against 243 individuals involved schemes of approximately $712 million worth in false billings, according to an announcement by HHS. CMS also suspended a number of providers.

Despite the increased use of breast-conserving therapy among women with early-stage breast cancer, many women continue to undergo mastectomy, according to a study from researchers at the University of Texas MD Anderson Cancer Center in Houston published in JAMA Surgery.

While Republicans continue to look at dismantling President Obama's Affordable Care Act, they are also working on plans to extend subsidies temporarily to the millions of Americans who may lose the financial assistance should the Supreme Court rule in favor of the plaintiffs in King v. Burwell.

In its proposed fiscal year 2016 funding bill, the House Appropriations Committee is looking to defund the Affordable Care Act, block additional funding for patient-centered outcomes research, and terminate the Agency for Healthcare Research and Quality.

If the Supreme Court rules that individuals in states on the federal marketplace are ineligible for subsidies, the annual consumer premium contribution could increase $3300 in 2015, according to an analysis from Avalere Health.

Although the introduction of new specialty drugs and increased investments into personal health data security, moderating forces will keep healthcare spending growth in check in 2016, according to a report from PwC's Health Research Institute.

Arkansas, Delaware, and Pennsylvania have all received tentative approval from HHS Secretary Sylvia Mathews Burwell to set up their own state-based insurance exchanges and move their residents off the federally facilitated marketplace.

Aledade, founded by Farzard Mostashari, MD, announced on Monday that it had raised $30 million to support its mission of partnering with independent primary care physicians to create accountable care organizations and further fuel the company's growth.

With a growing world population and a growing proportion of elderly, more people are living in suboptimal health around the world. A third of the world's population experienced more than 5 ailments in 2013, according to a study published in The Lancet.

An analysis of the Medicaid expansion plans of 6 states that have been granted Section 1115 waivers identified both the promise and limits that have emerged through these alternative expansion approaches.

Some hospitals in the United States are marking up costs approximately 10 times the Medicare-allowed costs. This equals a markup of more than 1000% for the same medical services.

The American Journal of Accountable Care recently interviewed Dr Jain about his decision to join CareMore, CareMore's innovative care model, and his perspectives on US healthcare.