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This week, the top managed care news included the Trump administration giving governors the power to overhaul section 1332 waivers under the Affordable Care Act (ACA); CMS disclosed a breach in the portal that agents and brokers use to assist consumers signing up for health coverage under the ACA; about one-third of all US healthcare payments in 2017 were tied to alternative payment models.

A report from RAND Corporation and the American Medical Association (AMA) describes how alternative payment models (APMs) are affecting multiple aspects of physician practice and offers guidance for efforts to improve APMs and help practices succeed in them.

Researchers aimed to compare the clinical effectiveness of oral anti-osteoporosis drugs based on the observed risk of fracture while receiving treatment through primary care in the United Kingdom and Spain.

Fewer than 4 out of 10 adults received influenza vaccinations last winter, the lowest rate in 7 seasons; methamphetamine use is rising across the United States, but it is overshadowed by opioids and fatal overdoses; tobacco giant Altria will stop selling e-cigarette “pods” and will pull almost all its flavored products from the market in an attempt to help curb teen vaping.

As Election Day 2018 nears, President Trump and Congress pulled off a rare feat, rallying around the signing of bipartisan legislation that will attempt to combat opioid use disorder, which took more than 42,000 lives in 2016.

A recent trial sought to assess the effect of palbociclib on overall survival (OS) and the efficacy of subsequent therapy in patients with hormone receptor–positive (HR+), HER2-negative advanced breast cancer.

President Donald Trump unveiled the latest steps his administration is taking to help Medicare drive down the costs of prescription drugs with a plan to allow CMS to determine the price it pays for certain drugs based on the prices that other countries pay.

Patients with nontuberculous mycobacterial lung disease (NTMLD) have a significant greater risk of hospitalization and higher total healthcare expenditures than matched control patients without NTMLD.

A new single-dose influenza vaccine that can be taken in the first days after symptoms of the flu start to appear has been approved; 102 million Americans with pre-existing conditions could be affected if protections under the Affordable Care Act are repealed; a federal advisory panel is recommending homeless individuals be routinely vaccinated for hepatitis A to prevent disease outbreaks, which have increased since 2016.

Amgen has announced that the price of its proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, evolocumab (Repatha), will be reduced by 60%, from an annual price of $14,100 down to $5850.

According to a study presented at the ESMO 2018 Congress in Munich, Germany, treatment with PD-1 or PD-L1 inhibitors is a feasible option for patients who have cancer and are living with HIV.

While the emergence of new antirheumatic agents—including biologics—has revolutionized the treatment of rheumatoid arthritis (RA), these drugs come a high cost to the healthcare system. Furthermore, many patients who receive these drugs may not respond to therapy, thereby increasing costs without improving outcomes.

A case report has revealed that clozapine with intermittent colony-stimulating factors helped treat leukopenia and neutropenia in a patient with chronic paranoid schizophrenia who responds only to clozapine.

Five unproven or potentially risky treatments have raised millions of dollars through crowdfunding campaigns since 2015; just 10 minutes of mild exercise can have an immediate impact on brain function; the Maine Attorney General’s Office has filed a brief supporting a lawsuit accusing Governor Paul LePage of breaking the law by trying to block Medicaid expansion.

A German study examined whether multidisciplinary inpatient treatment for chronic neuropathic pain leads to improvement of pain in outcome and psychological variables at posttreatment and 3-month follow-up.

The FDA’s approval of dupilumab, already approved for severe eczema, for asthma makes it the second biologic for the incurable lung disease.

Speakers at the National Committee for Quality Assurance’s Quality Talks meeting discussed challenges to improving healthcare delivery, such as changing behaviors, moving care outside of institutions, and rebuilding trust among marginalized populations.

The FDA announced it will consider ways to make naloxone more broadly available, including the possibility of coprescribing the opioid overdose antidote with some or all opioid prescriptions. In addition, CMS said it was creating a new care model to care for pregnant and postpartum Medicaid beneficiaries with opioid use disorder.

A phase 3 trial recently investigated if nanoparticle albumin-bound paclitaxel enhances the treatment of atezolizumab in unresectable locally advanced or metastatic triple-negative breast cancer.

Postoperative and preoperative start of low molecular weight heparin (LMWH) does not change the outcome of mortality or risk of reoperation in patients with hip fractures treated with osteosynthesis, according to a recent study.

The Trump administration will allow small employers to use tax-free health reimbursement accounts (HRAs) to provide health coverage to workers; the number of fatal drug overdoses nationwide has fallen for 6 consecutive months; a pilot study with a small sample size of 8 people discovered that microplastics can make their way into the human gut.

In reponse to rising healthcare prices and emergency department (ED) visits, insurers have implemented policies that apply financial disincentives for ED visits that could presumably be cared for in alternative settings. However, 87.9% of commercially insured ED visits present with the same primary symptoms as visits that result in nonemergent diagnoses.

A recently published cohort study with a register-based follow-up of some individuals from the Danish general population sought to investigate whether smokers are at an increased risk for developing MPNs versus those who have never smoked.

Approximately one-third of all US healthcare payments in 2017 were tied to alternative payment models, with the remaining still tied to fee for service. The findings of the Health Care Payment Learning and Action Network report highlighted that even as payments move to value-based models, more spending in models with risk is needed.

The Trump administration Monday moved to drastically overhaul section 1332 waivers under the Affordable Care Act (ACA), including giving governors the ability to seek more flexibility without legislative approval, and to encourage people to sign up for plans that are not ACA-compliant.

A new study has indicated that long-term treatment with onabotulinumtoxin A is effective, safe, and well-tolerated in the patient population.

The breach comes as the Trump administration hopes to rely more heavily on professionals to assist consumers during open enrollment.

Certain dermatologic/mucosal conditions, use of corticosteroids, and intravenous antibiotics prior to chemotherapy may increase the risk of febrile neutropenia.