Payers

In a 7 to 2 decision, the Supreme Court ruled Thursday that the Affordable Care Act (ACA) will stand, as plaintiffs seeking to declare the law unconstitutional did not have standing.

Mean in-network commercial allowed amounts and charges per anesthesia conversion factor are 314% and 659% of traditional Medicare rates, respectively. Medicare Advantage payments align with traditional Medicare prices.

On this episode of Managed Care Cast, we speak with the author of the annual PwC Behind the Numbers report, which looks ahead at medical cost trends in the United States.

This study evaluated cost and utilization attributed to members enrolled in a health care program with no pharmacy co-pay. Health care savings were identified in addition to medication adherence improvements.

Hospital performance measures, such as prices and costs, are associated with hospital-insurer contract types.

United States to buy and donate 500 million COVID-19 vaccine doses to the world; an FDA advisor resigns over a controversial Alzheimer drug approval; Nevada becomes the second state to offer state-managed health insurance plans.

In this episode of Managed Care Cast, we speak with a coauthor of an article in June’s Health Affairs examining the racial and ethnic composition of beneficiaries in Medicare Advantage plans and the potential implications as the program continues to grow.

Biomarker testing and remote patient monitoring are just 2 areas of research presented during the annual meeting of the American Society of Clinical Oncology (ASCO).

Equality in cancer care is not sufficient, said Lori Pierce, MD, FASTRO, FASCO, a radiation oncologist from the University of Michigan and president of the American Society of Clinical Oncology (ASCO). Equity—which means that patients have similar outcomes, regardless of circumstance—is harder to achieve.

Deploying vibration-controlled transient elastography/controlled attenuation parameter devices at the population level is a financially advantageous solution to address the epidemic of fatty liver disease.

Humana's Bold Goal program allowed the health care giant to test new delivery models that it used to address loneliness and food insecurity during COVID-19.

Patients with acute myeloid leukemia (AML) who relapse after first-line treatment face a substantial health care resource utilization (HCRU) and cost burden, according to a poster presented at Virtual ISPOR 2021.

In the April Matters in Managed Care webinar, leaders from Anthem and a partner of Anthem’s Doula Pilot Program in California discuss how a health plan can take an active role in reducing disparities in maternity mortality, which has been recognized by the World Health Organization as a growing health concern in the United States.

In the April Matters in Managed Care webinar, leaders from Anthem and a partner of Anthem’s Doula Pilot Program in California discuss how a health plan can take an active role in reducing disparities in maternity mortality, which has been recognized by the World Health Organization as a growing health concern in the United States.

In the April Matters in Managed Care webinar, leaders from Anthem and a partner of Anthem’s Doula Pilot Program in California discuss how a health plan can take an active role in reducing disparities in maternity mortality, which has been recognized by the World Health Organization as a growing health concern in the United States.

In the April Matters in Managed Care webinar, leaders from Anthem and a partner of Anthem’s Doula Pilot Program in California discuss how a health plan can take an active role in reducing disparities in maternity mortality, which has been recognized by the World Health Organization as a growing health concern in the United States.

In the April Matters in Managed Care webinar, leaders from Anthem and a partner of Anthem’s Doula Pilot Program in California discuss how a health plan can take an active role in reducing disparities in maternity mortality, which has been recognized by the World Health Organization as a growing health concern in the United States.

In the April Matters in Managed Care webinar, leaders from Anthem and a partner of Anthem’s Doula Pilot Program in California discuss how a health plan can take an active role in reducing disparities in maternity mortality, which has been recognized by the World Health Organization as a growing health concern in the United States.

In the April Matters in Managed Care webinar, leaders from Anthem and a partner of Anthem’s Doula Pilot Program in California discuss how a health plan can take an active role in reducing disparities in maternity mortality, which has been recognized by the World Health Organization as a growing health concern in the United States.

In the April Matters in Managed Care webinar, leaders from Anthem and a partner of Anthem’s Doula Pilot Program in California discuss how a health plan can take an active role in reducing disparities in maternity mortality, which has been recognized by the World Health Organization as a growing health concern in the United States.

Technological innovation is helping to reinvent the traditional health economics and outcomes research (HEOR) field as traditional and new players partner to leverage data sources.

Expanded coverage under a Medicare-Medicaid partnership to treat all prevalent cases of hepatitis C appears to be cost-effective by saving money and improving patient outcomes.

Stakeholders identify the value elements of comprehensive genomic profiling (CGP) they find most important, as well as options for innovative contracts.

As the cost of therapies increases, US health plans are utilizing tools like step therapy, to ensure patients try cheaper alternatives first, and value assessment frameworks, to assist with the decision-making process.

With more than 3000 gene therapies in development, payers will have to grapple with the challenges of paying for these innovative but expensive therapies.

Sessions, posters, and late-breaking trials at the American College of Cardiology’s 70th Scientific Session offer updates on vericiguat, SGLT2 inhibitors, sacubitril/valsartan, and heart failure therapies still in the pipeline.

Two posters presented at Virtual ISPOR 2021 analyzed the health care resource utilization and cost of patients with chronic obstructive pulmonary disease (COPD) with pneumonia, as well as the cost savings of treating patients with frequent or severe COPD exacerbations with a fixed-dose triple therapy.

The COVID-19 pandemic brought together the world and taught health systems how to be resilient and adapt to both predictable and unpredictable changes, said the panelists during the plenary on day 1 of Virtual ISPOR 2021.

Two top cardiologists debated evidence involving one clinical trial for omega-3 fatty acids, with implications for another, the REDUCE-IT study for icosapent ethyl (Vascepa).