California Lawsuit Blames Managed Care Network Inadequacy for Patient's Permanent Injury
December 16th 2014An attorney for the patient said this is the first lawsuit that alleges actual harm over inadequate networks, not just lack of access. California has had its share of growing pains through ACA expansion and its simultaneous expansion of managed care in its Medicaid program.
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Tennessee Announces Medicaid Expansion Option
December 15th 2014Tennessee became the latest Republican-led state to gain approval for a Medicaid expansion option when Gov Bill Haslam unveiled the Insure Tennessee plan Monday morning. There are just 20 states left that have not expanded Medicaid.
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Monitoring Drug Safety in the Age of Big Data
December 14th 2014Healthcare databases may allow for greater access to real-world medical data, but they can become a risk to patients and healthcare systems if they are not considered carefully, according to a study published in Current Epidemiology Reports.
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After Astra, Pfizer Taps Other Immuno-Oncology Markets
December 14th 2014With the immuno-oncology field getting more intense, Pfizer continues its struggle to gain a foothold in the field. Following unsuccessful attempts to bid for AstraZeneca, Pfizer has now signed a deal with a Belgian company, iTeos Therapeutics.
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Influence of Socioeconomic Status, Race on 30-Day Readmission Rates
December 11th 2014A new report has validated concerns that CMS readmission penalty models do not factor in socioeconomic and race factors and therefore unfairly penalize hospitals caring for low-income, uninsured, and vulnerable populations.
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Aetna Foundation Issues $4.5 Million Challenge to Accelerate Digital Health Innovation
December 11th 2014The Aetna Foundation announced the Healthier World Innovation Challenge, a $4.5 million initiative designed to steer digital health innovation to improve chronic health outcomes in underserved communities.
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States Offer Poor Access for Medicaid Managed Care Networks, OIG Report Finds
December 10th 2014As Medicaid enrollment grows under the program's expansion, there are not enough providers to serve the increased amounts of enrollees, according to a new report from the Office of the Inspector General that measured the availability of specific providers in Medicaid managed care networks.
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California Medicaid Acquisition a Sign of the Times, as Managed Care Goes After Growth
December 10th 2014Blue Shield of California seeks regulatory approval to buy Care1st, which would give the larger insurer a rapidly growing Medicaid plan. Commercial carriers are expected to eye Medicaid plans as a source of growth, especially in states that have approved expansion.
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Study: Doctors Paid More for Multiple Procedures Than for Multiple Patients
December 10th 2014Highly-paid doctors make more money ordering multiple procedures for individual patients than they earn seeing multiple patients, suggesting payment reform under the Affordable Care Act has yet to be realized.
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