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This Week in Managed Care: August 8, 2015
The top stories in managed care, including what providers really think about the use of quality metrics, readmission rates for Medicare patients, and preventing drug-resistant infections.
This week HHS found that competition among health plans in the Affordable Care Act’s insurance marketplaces helped consumers find the best prices. However, there are now concerns that if the mergers between Aetna and Humana, and Anthem and Cigna go through that they will decrease competition levels that led to better prices and premiums.
The use of quality metrics to assess providers’ performances is viewed negatively by primary care providers, along with financial penalties for unnecessary hospital admissions and readmissions. However, providers believe health information technology is having a positive impact on quality of care.
Under the Hospital Readmissions Reduction Program, 2592 hospitals will lose a combined $420 million dollars due to penalties as a result of their Medicare readmission rates. One in 5 Medicare patients is still readmitted to the hospital within 30 days of discharge.
Prices for care at hospital trauma centers vary across hospitals; drug shortages reached a record high during the first quarter of 2024; although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by the youngest kids with asthma.
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Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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The Biden administration recently launched the Global Health Security Strategy, a new effort to combat the spread of infectious diseases; lawmakers zeroed in on the risks of massive consolidation in health care during the first congressional hearing on the Change Healthcare hack; the FDA recently announced the recall of a pair of heart devices linked to numerous deaths and injuries.
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Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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