May 8th 2025
A study reveals higher health care costs and resource use for uncomplicated urinary tract infections (uUTIs), emphasizing the need for improved patient management strategies.
Health Insurers Seek Sharp Rate Increases in 2016
July 5th 2015Newly insured consumers under the Affordable Care Act have turned out to be sicker than initially estimated, according to health insurance companies, who are seeking rate increases of at least 20% to 40%, reported the New York Times.
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Americans Mostly Approve of King v. Burwell Decision
July 5th 2015Although nearly equal amounts of people view the Affordable Care Act favorably (43%) as unfavorably (40%), a majority of Americans say they approved of the Supreme Court's decision to continue to allow Americans living in states on the federally facilitated exchange to be eligible for insurance subsidies, according to a recent poll by the Kaiser Family Foundation.
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This Week in Managed Care: July 4, 2015
July 4th 2015This week GOP presidential candidate hopefuls turned their attention to the 2016 election as the next best chance to repeal Obamacare, and CMS released data revealing $6.5 billion payments to healthcare providers from drug and medical device makers in 2014.
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New Study Details Step-by-Step Process For Improving Population Health
July 3rd 2015In addition to increasing insurance coverage, the Affordable Care Act also aims to improve population health and lower healthcare costs. However, not much attention has been paid to the quality of care the newly insured are receiving.
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Why the King v. Burwell Ruling Is Good News for Millions of Americans
July 1st 2015The health coverage of millions of Americans in 34 states was pending upon the Supreme Court decision on the King v Burwell case. Luckily, common sense prevailed and the Supreme Court based its ruling on the original motivation behind the creation of the exchanges rather than on the plain language used in the provision.
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CMS Continues Implementation of ACA's Premium Stabilization Programs
July 1st 2015CMS has begun to implement risk adjustment and reinsurance programs, 2 premium stabilization programs of the Affordable Care Act. The report highlighted the estimated reinsurance payments issuer in addition to summary level information on the programs, which helps to keep premiums affordable as well as various coverage options available to consumers.
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Medicare Advantage Enrollment Climbs, but So Do Financial Burdens
July 1st 2015Despite concerns that Medicare Advantage payment reductions included in the Affordable Care Act would lead to a decline in enrollment, the number and share of beneficiaries enrolling in Medicare Advantage has only continue to climb since the health reform law was enacted.
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Low Premium Plans Increase Marketplace Price Competition
June 30th 2015In an effort to better examine and understand the implementation and effects of the Affordable Care Act, researchers from the Urban Institute found that nongroup health insurance premiums in insurance marketplaces were lower than expected.
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Police Untrained to Handle People Suffering From Mental Health Issues
June 30th 2015Police officers in the United States are woefully untrained to approach individuals with behavioral health issues, according to a new analysis from Washington Post. In the first 6 months of 2015, police have shot and killed 123 people in the throes of mental or emotional crisis.
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Avik Roy Speculates on the 2016 Presidential Election and the ACA
June 29th 2015Although GOP presidential hopefuls are all campaigning on promises to repeal and replace President Obama's Affordable Care Act (ACA), the last real chance to repeal may have been the 2012 election, according to Avik Roy, senior fellow at the Manhattan Institute.
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GOP Presidential Hopefuls Still Eye 2016 Election as Chance to Repeal Obamacare
June 29th 2015Shortly after the Supreme Court ruled in favor of the government in King v. Burwell, President Barack Obama triumphantly claimed that "Affordable Care Act is here to stay." However, the truth is that GOP presidential hopefuls have no intention of letting the law stand.
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The Country's Sharply Divided Reactions to King v. Burwell Ruling on Subsidies
June 26th 2015With the Supreme Court ruling in King v. Burwell keeping subsidies available to consumers on the federally facilitated marketplace, healthcare associations, insurers, health plans, and other stakeholders have been voicing their support and relief at the 6-3 ruling.
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Despite Subsidies Upheld in Marketplaces, Some Americans Continue to Prefer Staying Uninsured
June 25th 2015The Supreme Court may have kept subsidies available to all Americans regardless of whether their state has set up its own exchange, but some people still refuse to purchase coverage, and they're perfectly happy remaining uninsured.
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SCOTUS Upholds ACA Subsidies on HealthCare.gov in King v. Burwell
June 25th 2015In a triumphant win for President Obama's Affordable Care Act and millions of Americans, the Supreme Court of the United States ruled against the plaintiffs in the case King v. Burwell and upheld the availability of subsidies for individuals on the federally facilitated marketplace.
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40% of Physician Networks Could Be Considered Narrow
June 24th 2015A new study summarizing network size by physician, not just hospital participation, determined that 41% of networks on the marketplaces can be considered small or x-small and contain just 25% or less of office-based physicians in the area.
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CBO Largely Uncertain of the Full Economic Effects of Repealing the ACA
June 23rd 2015There have been numerous attempts to repeal part or all of the Affordable Care Act since it became law, and the Congressional Budget Office admits its estimates on the effect of repealing the law are all subject to "substantial uncertainty."
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Despite Increase in Patients Under ACA, PCPs Report No Change in Quality of Care Provided
June 22nd 2015During the first year of health coverage expansion under the Affordable Care Act, many primary care providers said the number of patients they saw increased, but reported no compromise in quality of care provided, according to a study from the Kaiser Family Foundation and The Commonwealth Fund.
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This Week in Managed Care: June 20, 2015
June 20th 2015This week 3 states received approval to set up their own state exchanges in the even the Supreme Court removes subsidies in the federally facilitated marketplace, and the deadline passed for stakeholders to respond to CMS' proposed rules for mental health parity in Medicaid managed care.
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