Articles by Mary K. Caffrey

Last night's announcement came in a video release featuring President Obama and HHS Secretary Sylvia Mathews Burwell. The president cited the Affordable Care Act's reach into previously underserved markets and the increased level of consumer choice in 2015; increased competition as the law goes forward will drive down premiums over time, he said.

Iowa's timetable calls for receiving bids by May 8, 2015, and signing a contract by August 28, 2015. Officials want the program up and running January 1, 2016, because they seek $51 million in savings in the first 6 months.



Open enrollment under the Affordable Care Act lacked the chaos and drama of 2014, thanks to improvements in HealthCare.gov. But there is still plenty of uncertainty ahead, as the fate of financial supports rests with the US Supreme Court.

Like other states, New Hampshire has promised better coordination of care for its Medicaid population. But those who have moved into managed care thus far report having to fight for services that previously came without incident.

The study evaluated average cost-sharing for those receiving subsidies in Silver Plans in the 37 states that would be affected by King v. Burwell. In that case, plaintiffs argue that the plain language of the Affordable Care Act does not allow consumers to receive subsidies if they live in states using the federal heath insurance marketplace.

If the Dietary Guidelines Advisory Committee drops cholesterol from the list of "nutrients of concern," it will be consistent with a 2013 task force finding as well as the panel's focus on dietary patterns, or the mix of foods that Americans eat and their effect on population health.

An editorial accompanying the meta-analysis discussed the challenges physicians face when evaluating individual patient needs against guidelines. In the United States, the movement toward reimbursement based on population health measures has raised questions about whether it makes sense for patients to be given multiple medications to achieve small improvements toward targets. Results must be weighed against increased side affects or large out-of-pocket expenditures.

Researchers were not sure whether breast cancer patients were refusing radiation or whether women and their physicians have a lack of awareness of its importance after a mastectomy.

Governor Bill Haslam's expansion plan had market-based elements, a way to cover the state's share, and a deal to leave early if it cost too much. But distrust of the federal government and the president in particular was too much to overcome.

Following an announcement that Medicare would cover preventive low dose computes tomography for lung cancer screening, CMS released a final national coverage determination today that includes details on eligibility criteria.

Making lifestyle changes is far more important to reducing cancer risk than avoiding food additives or worrying about genetics. But a survey by the American Institute of Cancer Research finds most people in the United States worry more about the things for which risks are unproven, while overlooking risks for which the science is clear.

Children, the poor, African Americans, and those living in rental housing remain at higher risk of exposure to secondhand smoke, which CDC says kills 41,000 nonsmoking adults and 400 infants a year.

The Agency for Healthcare Research and Quality (AHRQ) is a comparatively small part of the federal budget, but its research priorities for FY 2016 affect areas that consume huge sums.

Governor John Kasich changed eligibility rules to add 450,000 Ohioans to Medicaid last year. The budget he presents to the Legislature will be silent on reauthorizing those rules, but will call for changes to find savings elsewhere in the program.

California advocates worry that having half its children in Medi-Cal will mean poor access to care. But the real issue may be the growing number of poor children nationwide and the overall effect on Medicaid.

Reports say NIH would receive funds to collect DNA from 1 million volunteers, the National Cancer Institute would get research funds, and FDA would get support to regulate molecular diagnostic tests. The plans need funding from Congress.

The Genetic Information Nondiscrimination Act (GINA) protects most consumers from losing health coverage or their job if they pursue genetic testing. But authors of a new article in The New England Journal of Medicine explore the implications of testing for life, disability and long-term care insurance.

Meeting enrollment goals for the Affordable Care Act proved the easy part for the HHS in 2015. The hard part will come March 4, 2015, when the US Supreme Court will hear a case that could eliminate financial subsidies for millions who signed up, putting their health coverage at risk.

Hospital leaders express the same concerns heard in Florida, Alabama, and elsewhere since the midterms: refusing to expand Medicaid to the working poor leaves thousands without coverage, and they still come to emergency rooms for routine care. The problem is, the Affordable Care Act assumed that expansion would be universal, and funds to care for the uninsured have dried up.

As the personalized medicine initiative takes shape, word comes that CMS will pay for key genetic tests in lung cancer. This policy shift is a sea change after a long period of frustration for test makers in seeking reimbursement.







