Health Care Cost

The top stories in managed care were discussions of value-based care at the NAMCP Fall Managed Care Forum, hospitals are suing over Horizon Blue Cross Blue Shield of New Jersey's OMNIA plan, and CMS finalizes its bundled payments for joint replacement.

The HHS Pharmaceutical Forum brought together a diverse set of stakeholders to share ideas on delivering affordable but high-quality care, improving outcomes, and continuing to lead in innovation. Here are 5 things that came out of the daylong meeting.

CMS has finalized a rule for a bundled payment test for hip and knee replacements that will be mandatory for nearly all hospitals in 67 geographical areas across the country.

The Medicare Shared Savings Program is the perfect way for primary care physicians to get involved with alternative payments as Medicare moves to replace fee-for-service, explained Hymin Zucker, MD, chief medical officer of the Triple Aim Development Group.

As the healthcare industry positions itself for the change to value-based care, there needs to be a widespread change in terms of collaboration between physicians, hospitals, and payers.

According to the CDC, while smoking rates are seeing a steady decline, rates for uninsured and adults on Medicaid are more than twice those for adults with private health insurance.

A forced closing of Health Republic Insurance of New York has left many in need of immediate coverage.

Heterogeneity in quality of care and cancer patient survival based on insurance coverage are the highlight of a report by researchers at the Institute for Population Health Improvement at the University of California Davis.

When accountable care organizations first started forming, the country thought it would be easier than it has been, but finding the right partner is crucial, said Pam Halvorson, regional vice president of clinic operations with Trinity Pioneer ACO.

What we're reading, November 3, 2015: off-label drug use is associated with a higher risk of adverse drug events; CMS finalizes its rule for advanced care planning for end-of-life care; and Californians send measure to cut drug prices to the vote.

The Community Oncology Alliance (COA) created its Payer Exchange Summit to get payers who are thinking about getting involved in oncology payment reform or want to know what to do exposed to successful pilots, explained Ted Okon, MBA, executive director of COA.

Payer—provider teams presented updates on their cost-saving pilot projects and looked to the future of these models in oncology care.