Health Care Delivery

A review of the benefit design choices made by states that expanded Medicaid (as of the end of 2014), revealed that states are offering more generous coverage that what is required under federal law, according to researchers with The Commonwealth Fund.

Consumer protections and rules to promote the march to value-based care are highlights of the massive proposal.

Innovative care delivery programs intended to improve quality and reduce costs need sustainable business models in order to last beyond the end of grants or other methods of time-limited funding. RAND researchers take a look at methods Massachusetts health plans and accountable care organizations are using.

The Obama Administration says that Florida can receive $1 billion this year and $600 million next year to pay for uncompensated care in safety net hospitals. However, the administration made it clear that more funding awaits the state if Medicaid expansion reaches those up to 138% of the federal poverty line.

Consumers with chronic diseases face challenging trade-offs when choosing health coverage, especially when it comes to out-of-pocket drug costs.

The implementation of the Affordable Care Act and its resulting market turbulence has not created the operation challenges for payers that was expected, according to a report from athenahealth, Inc.

Although millions of Americans have gained health insurance under the Affordable Care Act, the Commonwealth Fund recently found that 31 million individuals were underinsured in 2014.

While there's been controversy around the drug discount program for some time, the Health Resources and Services Administration plans to release a "mega-guidance" that will address several aspects of the 340B program.

The authors discuss the success of the Pioneer ACO model and the Comprehensive Primary Care Initiative, among others. They outline an agenda that includes engaging managed care stakeholders, so that both public and private payers are moving toward value-based payment.

Coverage of the 64th Scientific Sessions of the American College of Cardiology.

Coverage from the 64th Scientific Sessions of the American College of Cardiology.

The most sweeping overhaul of Medicaid regulations since 2002 is due soon. So far there are few hints at what CMS may require states to do as they award managed care contracts in an effort to better coordinate care and control costs.