Health Care Delivery

An initiative by Horizon Blue Cross Blue Shield of New Jersey to implement integrated, value-based care on a wide scale has run into criticism from legislators who say it will bring financial harm to some safety net hospitals. A Senate hearing today concluded with a call for an investigation from the Attorney General into how the alliance was created.

Reimbursement remains a primary concern with the new immuno-oncology agents. Who pays and how do you ensure payment was fervently discussed by oncologists at the recent ICLIO meeting hosted by the Association of Community Cancer Centers.

A study reports that despite the steady growth in hospital-based palliative care programs, access is sketchy and is driven by geographic location and hospital ownership.

Patient access to innovation may be at risk as new payment models emerge in oncology.

The findings come as CMS is poised to finalize a rule to pay doctors to counsel patients about end-of-life treatment options.

Kevin W. Wildes, SJ, PhD, said that Pope Francis' call for access to healthcare leaves the specifics up to US leaders, as the church does not say that one system is better than another.

Healthcare networks around the country will be getting some financial help from HHS to improve quality of care, increase patient access to information, and reduce costs.

Eighty-six million US adults are at high risk of developing type 2 diabetes. Without prevention, there will be a drastic increase in the number of Americans who will develop type 2 diabetes.

A new report from The Commonwealth Fund has found similarities between premium costs for marketplace enrollees and those with employer plans. According to Are Marketplace Plans Affordable?, 60% of marketplace enrollees and 55% of individuals with employer plans pay either nothing or less than $125 a month for individual coverage.

More than $100 million in Affordable Care Act funding is being awarded to 17 national, regional, and state hospital associations and health system organizations to assist efforts to reduce hospital-acquired conditions and readmissions.

Many hoped the 2013 declaration by the American Medical Association that obesity is a disease would open the door for payer coverage of pharmacotherapy to treat it. While that did not happen right way, a new commentary in Evidence-Based Diabetes Management by Ted Kyle, RPh, MBA, and Fatima Cody Stanford, MD, MPH, MPA, outlines how the tide appears to be turning for coverage of evidence-based treatment.

The earlier you intervene with patients with mental health issues, the better the outcome for both the individual and the health system. Early intervention prevents pain and suffering and actually saves costs in the long run, said John Santopietro, MD, chief clinical officer of behavioral health at Carolinas HealthCare System.

Telehealth follow up consultations after a surgical operation have become preferred compared to in-person visits, according to 2 recent studies.

The problem in Kansas is the same as other states without Medicaid expansion: the ACA envisioned universal coverage, and funds to treat the uninsured are dwindling because it was expected that patients who are now in a "gap" would have insurance.

As enrollment in Medicare Advantage is expected to increase to a new all-time high for the sixth year in a row, CMS announced that Medicare Advantage premiums will remain stable in 2016.

The implementation of the Affordable Care Act (ACA) has reduced the number of uninsured Americans and created significant gains in health coverage among racial and ethnic minorities. However, the ability of Obamacare to reduce racial and ethnic disparities has been limited.

An analysis of the competitive landscape of the public health insurance exchanges as it has so far unfolded has revealed that despite challenges to date, the exchanges have been attracting new entrants.

The top stories in managed care include the nomination for the next FDA commissioner, a report reveals cancer drugs are driving growth in the 340B program more than initially thought, and nearly half a billion in ACA funds are made available to health centers.

As the United States looks to reform its healthcare system to provide better value at lower costs, the real challenge is innovating at scale across the country, said Joseph Gifford, MD, chief executive officer of the Providence-Swedish Health Alliance.

Many hoped the 2013 declaration by the American Medical Association that obesity is a disease would open the door to improved coverage for pharmcotherapy. That did not happen right away, but signs of change are emerging.

The path to President Obama's Precision Medicine Initiative has been paved as is evident from a report released by a Working Group convened by the National Institutes of Health.

While employers will continue to shift healthcare costs to employees, a new report found that the underlying cost growth, which employers would expect if they did not make changes such as raising deductibles or switching carriers, will slow in 2016.

At the recently held NCCN healthcare policy summit in Washington, DC, experts delved into various models being evaluated to reduce healthcare utilization in oncology care.

Healthcare policy makers, payers, medical centers, and patient representatives shared the dais as they discussed The Value Proposition in oncology.

The report included some famous examples of states that had to abandon early IT efforts despite large sums spent