January 31st 2023
The government is allowing Medicare Advantage (MA) plans to delay returning hundreds of millions of dollars or more in government overpayments; a proposed new extension of the Affordable Care Act (ACA) might make birth control coverage more accessible for certain private insurance plans; a study found that students lost around 33% of their school year because of the pandemic’s educational barriers and are struggling to regain that lost time.
Contributor: Promoting Health Equity Through Primary Care
January 23rd 2023Jodi Fenner, senior director at Elevance Health, speaks on the key themes she presented during her session at the 2023 Health Equity Summit in San Diego, California, titled, "Promoting Health Equity through Primary Care."
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Health Equity Decision-making: A Q&A With Dr N. Benjamin Fredrick
January 23rd 2023N. Benjamin Fredrick, MD, of Penn State Hershey Medical Center and Penn State University College of Medicine, speaks on the key themes he presented during his session at the 2023 Health Equity Summit in San Diego, California, as well as topics related to the measurement, creation, and implementation of health equity initiatives.
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Newer Drugs for Epilepsy Less Likely to Be Prescribed to Black, Latino Patients on Medicaid
January 11th 2023Patients with epilepsy on Medicaid insurance of Black, Latino, and Native Hawaiian and Other Pacific Island ethnicity were associated with lower odds of being on newer, second- and third-generation, antiseizure medications compared with White individuals.
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Spotlighting Health Disparities for Black Americans With Multiple Myeloma and Potential Solutions
January 11th 2023Black Americans with multiple myeloma face disparities in incidence of disease, survival outcomes, and use of evidence-based treatment, which may be exacerbated by socioeconomic factors.
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Limited Appointment Availability and Cost Largest Obstacles to Women’s Mental Health Care
January 5th 2023In the last 2 years, half of women reported needing mental health services compared with only 35% of men. Women who needed mental health care cited provider availability and cost, especially for those who are uninsured, to be 2 major barriers to receiving care.
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PBMs Announce 2023 Coverage Plans for Adalimumab Biosimilars
January 1st 2023The addition of adalimumab biosimilars to formularies can help accelerate realized savings as the blockbuster drug Humira faces competition from multiple biosimilars, including 1 approved interchangeable biosimilar.
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Top 5 Most-Viewed Reimbursement Content in 2022
December 30th 2022The top 5 pieces of content published on AJMC.com relating to reimbursement issues included 2 on the significance of a California law giving Medicare beneficiaries access to expert oncology care; other articles looked at the work involved in value-based care models and CMS news.
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Use of PRO Measures Lacking in Acne Vulgaris and Rosacea Clinical Trials, Study Finds
December 2nd 2022Patient-reported outcome (PRO) measures were included in approximately one-half of acne vulgaris and rosacea randomized controlled trials, despite their utility in capturing the patient perspective.
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HDHPs Deter Women From Additional Testing After Abnormal Mammogram, Study Says
November 29th 2022The groups who told researchers they would be more likely to skip additional testing had lower levels of income or education and were more likely to be on Medicaid or be uninsured, among other factors.
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MA Beneficiaries May Be at Disadvantage for Complex Cancer Surgeries
November 21st 2022Patients with Medicare Advantage (MA) were 1.5 times more likely to die within a month of surgical removal of their stomach or liver, and twice as likely to die within a month of oncologic surgery of the pancreas, compared with patients with traditional Medicare.
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Michael Thompson Reviews Findings of National Alliance’s Pulse of the Purchaser Fall 2022 Survey
November 16th 2022Michael Thompson, president and CEO of the National Alliance of Healthcare Purchaser Coalitions (National Alliance), discussed findings of the survey that was presented at the National Alliance 2022 Annual Forum and what concerns employers and business coalitions had regarding the current state of health care cost, delivery, and coverage.
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Providers Must Educate Congress, CMS on Reality of Oncology Practice Finances, Dr Kavita Patel Says
November 14th 2022Former Obama administration official Kavita Patel, MD, MS, told a gathering of the OneOncology Physician Leadership Conference that policy leaders and members of Congress need input on the realities of oncology practice finances.
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Dr Timothy Murphy: Strong Communication Is Necessary for Practices Stocking Multiple Biosimilars
November 13th 2022With multiple biosimilars approved for a reference product and different payers preferring particular products, communication between the clinical pharmacy team and the managed care team is crucial, said Timothy Murphy, MD, FACP, medical oncologist/hematologist with Rocky Mountain Cancer Centers.
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Dr Davey Daniel Hits the High Points of the OneOncology Annual Conference
November 12th 2022The OneOncology Annual Conference is being held November 11-13 in Nashville, Tennessee, and brings together practice leaders, physicians, and advanced practice providers to discuss the business of oncology and scientific advancements, explained Davey Daniel, MD, chief medical officer of OneOncology.
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Panel Addresses How Payers, Providers Can Optimally Use Real-World Evidence to Advance Cancer Care
November 10th 2022Utilizing real-world evidence that applies to the specific care needs of certain patient populations can promote timely decision-making among payers and providers on the use of effective cancer therapies available on the market, said panelists at the 2022 Patient-Centered Oncology Care® (PCOC) meeting.
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