Limited Literacy, Numeracy Hurts Those the ACA Is Meant to Help
November 2nd 2014The Affordable Care Act expanded healthcare coverage to many low-income Americans, but this same demographic has a low health literacy that makes it difficult for them to navigate program eligibility systems, according to a study from The Urban Institute.
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Test Predicts Benefit of Extended Endocrine Therapy in Breast Cancer Patients
November 2nd 2014bioTheranostics, Inc's Breast Cancer Index, a genomic test quantifying the risk of breast cancer recurrence and predicting which patients will likely benefit from extended endocrine therapy, will be covered by Medicare.
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Diagnostic Lung Biopsies a Big Drain on Medicare, Study Finds
October 31st 2014The retrospective study, results of which were presented at the 2014 Chicago Multidisciplinary Symposium in Thoracic Oncology, showed that the total diagnostic workup cost for the study sample of Medicare beneficiaries was $38.3 million.
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Author Finds High Degree of Variation Among States to Accommodate Accountable Care
October 31st 2014From Medicaid providers that are regulated as insurers alongside managed care organizations, as happens in Mississippi, to "enhanced medical homes," which are found in Colorado, the variety that exists in healthcare delivery across the states has adapted to reflect the shift to accountable care, according to an author writing for the American Journal of Public Health.
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Extending Hospital Stays by One Day Reduces Readmission, Mortality Rates
October 31st 2014In 2015, hospital readmissions will be a growing concern as the maximum penalty increases to 3% of Medicare payments. Researcher from Columbia Business School found that one extra day in the hospital can make all the difference to readmission and mortality rates.
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Healthcare Transformation and the Price of Pharmaceuticals
October 30th 2014Panelists discussed the price of pharmaceuticals and controlling the cost of care at the 64th Annual Roy A. Bowers Pharmaceutical Conference: A Measured Approach-Health Care Delivery and Transformation in a Metric Driven World, held by Rutgers University.
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If You Thought Managed Care Wars Were Ugly, Meet "Narrow Networks"
October 30th 2014From the youngest patients to the oldest, the Affordable Care Act's promise that care will be provided despite pre-existing conditions is bumping against the challenge of keeping costs in check. From around the country come reports of pushback, which evoke the 1990s stories of managed care's debut: limited choice.
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Privately Insured Consumers Spending More on Fewer Medical Services
October 29th 2014Despite using fewer medical services, privately insured Americans spent more money on these services in 2013, according to a report from the Health Care Cost Institute. The average enrollee in an employer health plan increased spending by 3.9% last year.
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CMS Vows New Medicaid Managed Care Rules in 2015
October 29th 2014A crackdown to ensure that Medicaid beneficiaries get accurate information about provider networks is coming in January, CMS officials vowed yesterday, according to published reports. New regulations for Medicaid managed care to be unveiled in early 2015 will ensure that consumers get timely access to care and better integration of services.
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Dr Karen B. DeSalvo Not Leaving ONC Just Yet
October 29th 2014The Office of the National Coordinator for Health Information Technology (ONC) seemed to be in dire straits as its leadership slowly left for other jobs. However, despite Dr DeSalvo's new position within HHS, she will maintain her leadership position in ONC, according to a new report.
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Prostate Cancer Screening Remains Highly Debated
October 29th 2014While the USPSTF recommended against screening for prostate cancer, citing the high rate of false positives, complications from biopsy, and side-effects of aggressive treatment for a sometimes slowly-progressing disease, several medical organizations disagree.
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AMA Expresses Concerns Over ONC Departures
October 28th 2014The American Medical Association voiced concerns over the fact that in addition to the departure of Karen. B. DeSalvo, MD, MPH, several other senior staff have recently left the Office of the National Coordinator for Health Information Technology.
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Friction Between Health Plans, Pharma Grows Over Specialty Drugs
October 28th 2014The war of words between managed care and pharmaceutical manufacturers, which began when Gilead set the price for its drug to treat the hepatitis C virus (HCV), has taken off in October with the reclassification of a trio of cancer drugs from Genentech. Growth in the "specialty pharma" sector, where prices are rising much faster than drug prices generally, has drawn concern from payers and the umbrella group that represents them, while the trade group that represents drugmakers is pushing back against critics, saying that it faces challenges in bringing life-saving therapies to market.
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