All News

CMS has announced proposed changes to the 2017 health insurance marketplaces aimed at providing choice and competition for consumers and improvements in consumer experience.

A recent study published by JAMA Surgery intended to pinpoint risk factors for hospital readmission in patients who underwent an emergency general surgery procedure, in hopes of finding out what decreases readmissions in the long run.

The top stories in managed care were discussions of value-based care at the NAMCP Fall Managed Care Forum, hospitals are suing over Horizon Blue Cross Blue Shield of New Jersey's OMNIA plan, and CMS finalizes its bundled payments for joint replacement.

Three years after Memorial Sloan Kettering Cancer Center refused to add Zaltrap to its formulary due to cost, value is part of the national conversation in cancer care. The new question is what will happen when physicians assume risk.

A pharmacist who engages in formulary decisions, a medical director for population management for a private health exchange, and an innovations leader at a pharmacy benefit manager, took to the podium at the Patient-Centered Oncology Care meeting on November 20, 2015, to discuss cost-saving strategies in oncology and whether benefit managers can play a role in reining-in some of these costs.

The findings suggest that addressing heart patients' social needs is the first step toward getting them to exercise more.

The HHS Pharmaceutical Forum brought together a diverse set of stakeholders to share ideas on delivering affordable but high-quality care, improving outcomes, and continuing to lead in innovation. Here are 5 things that came out of the daylong meeting.

What we're reading, November 20, 2015: CMS wants to penalize doctors for ordering routine prostate-cancer screening tests; lawmakers, patients, and advocates call for head of Drug Enforcement Agency to be fired; and specialty drug costs exceed household incomes.

A panel that discussed the prospect of FDA regulation of diagnostic tests in oncology helped open Patient-Centered Oncology Care November 19, 2015, in Baltimore, Maryland.

At the Patient-Centered Oncology Care 2015 meeting, held November 19-20, 2015, in Baltimore, Maryland, keynote speaker Julie M. Vose, MD, MBA, FASCO, president of the American Society of Clinical Oncology provided perspectives on the challenges faced by oncologists as the healthcare system transitions to define and incorporate value in the care delivered.

Rates of uninsured individuals vary dramatically across the country, and while some states made huge gains in covered individuals, others have lagged behind.

Steven M. Goldman, a former NJ insurance commissioner, sued the department he once led on behalf of a group of hospitals, saying officials had abdicated their duty in approving Horizon's tiered network plans.

The study population took part in the landmark ORIGIN trial, which evaluated hypoglycemia effects in persons with high CV risk and diabetes.

Collaboration between organizations serving the young adult cancer population benefits all involved

Due to poor performance in the Affordable Care Act's health insurance exchange's, UnitedHealth Group is considered pulling its plans from the exchanges in 2017.

Eligibility for prescription coverage and family income significantly influenced women's decisions to continue hormonal therapy and prevent recurrence of breast cancer, the authors found.

A majority of life sciences companies are planning on acquisitions and are targeting companies with a personalized medicine focus.

What we're reading, November 19, 2015: the American Medical Association is calling for a ban on direct-to-consumer television advertisement of prescription drugs and popular silver plans on HealthCare.gov have largest premium increases.

The American Society of Clinical Oncology has made public its detailed guidance to CMS, supporting implementation of physician-focused and other alternative payment models under MACRA.

The hiring of William J. Castner, Jr., comes after St. Peter's Hospital won the right to a hearing where the insurer will have to give more details on why it left the hospital out of its OMNIA network. However, a spokeman for the insurer said the hiring is due to a restructuring.

This is the company's third biosimilar Biologics License Application in the United States.

The study found that 1 in 10 Americans struggles with a drug use disorder at some point in their lives.

A weight-loss cell phone app alone did not help overweight young adults sustain weight loss any better than a written handout did.

The action by NICE highlights discussion on both sides of the Atlantic about the cost of PCSK9 inhibitors, which lower LDL cholesterol.

Although, data on predictive risk factors for chronic obstructive pulmonary disease has been limited until now, researchers from the United Kingdom recently developed a model for predicting exacerbation risk using data obtainable from primary care.

What we're reading, November 18, 2015: global drug spending is expected to grow 30% in 5 years; Robert M. Califf, MD, sits through mostly friendly senate confirmation hearing for FDA nomination; and moderate coffee consumption could reduce some risks of death.

CMS has made available $32 million in funds to support efforts to further reduce the rate of uninsured children who are eligible for Medicaid or the Children's Health Insurance Program.

The drug is estimated to cost close to $13,000 per month.

Critics say there's little documentation for the $51.3 million in savings the Branstad administration says it will achieve in the first 6 months of 2016.

It is time to regulate laboratory-developed tests that cost Medicare $9.7 billion in the year 2012 alone.