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Health plans on the Affordable Care Act (ACA) exchanges will be required to display quality ratings starting with the 2020 plan year, according to an announcement from CMS, which is expanding the 5-star rating system it uses on Medicare plans to the health insurance exchanges.

This week, the top managed care stories included the Trump administration looking to bar legal immigrants from using public benefits; a study in The American Journal of Managed Care® finding that a law to limit surprise medical bills is working; data on Affordable Care Act enrollment showing the effect of subsidies.

The August issue of The American Journal of Managed Care® (AJMC®) featured research on surprise medical billing policies, social determinants of health, and the value of chimeric antigen receptor T-cell therapies, among other topics. Here are 5 findings from research published in the issue.

Generic drug makers are being accused of blocking a Congressional probe into their pricing practices; Illinois has become the first state to require insurance companies to pay for EpiPens for kids in cases of severe allergic reactions; Tufts Health Plan and Harvard Pilgrim Health will merge to create a new company covering 2.4 million people across New England.

FDA's approval of entrectinib for neurotrophic tyrosine receptor kinase (NTRK) fusion-positive tumors represents a new paradigm in cancer treatment; It treats a cancer based on a common biomarker seen across different tumors rather than based on the location in the body where the cancer originated. The FDA also gave approval to entrectinib for the treatment of adults with metastatic non–small cell lung cancer whose tumors are ROS1 positive.

Timothy R. Smith, MD, RPh, is president and chief executive officer of StudyMetrix Research. He is a fellow of the American College of Physicians and the American Headache Society, a certified physician investigator of the Academy of Clinical Research Professionals, and vice president of the National Headache Foundation. Dr Smith has a special interest in patient and physician issues related to the treatment of headache in primary care. This is part 2 of an interview conducted by an editor from The American Journal of Managed Care®.

Timothy R. Smith, MD, RPh, is president and chief executive officer of StudyMetrix Research. He is a fellow of the American College of Physicians and the American Headache Society, a certified physician investigator of the Academy of Clinical Research Professionals, and vice president of the National Headache Foundation. Dr Smith has a special interest in patient and physician issues related to the treatment of headache in primary care. This is part 1 of an interview conducted by an editor from The American Journal of Managed Care®.

The National Institute of Allergy and Infectious Diseases, the World Health Organization, and the Congolese government announced that 2 experimental antibody-based treatments for Ebola are working so well that they will now be offered to all patients in the Democratic Republic of Congo; enrollment in insurance exchanges under the Affordable Care Act remains stable for people with lower incomes who received subsidies, but premium increases caused a 24% decline for people who did not qualify for assistance; scientists are repurposing old drugs or combining them with traditional antibiotics in an effort to combat antibiotic-resistant bacteria.

As our country continues its push to lower the cost of healthcare, especially among the burgeoning population of seniors with age-related disabilities, transitioning to a value-based insurance design payment model that rewards value, rather than quantity, will become progressively more important. In the realms of musculoskeletal pain and movement dysfunction, this transition must be accompanied with sincere efforts to identify treatments that can effectively manage pain and reduce the total cost of care.

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