Health Care Delivery

To mark the 25th anniversary of the journal, each issue in 2020 will include an interview with a healthcare thought leader. For the April issue, we turned to Sherry Glied, PhD, dean of New York University’s Robert F. Wagner Graduate School of Public Service.

A record number of Americans filed for unemployment last week; President Trump decides not to reopen Affordable Care Act enrollment; a survey found a majority of physicians say they cannot test for COVID-19 fast enough.

As the Affordable Care Act (ACA) turns 10 years old, the coronavirus pandemic is focusing a spotlight on the coverage gains made under the landmark law.

Research highlighting these trends, based on 10 million death records pulled from a CDC database, will be presented at the American College of Cardiology’s Annual Scientific Session together with World Congress of Cardiology (ACC.20/WCC), which is taking place as a virtual meeting March 28-30.

This week, the top managed care news included the COVID-19 crisis bringing changes to telehealth and testing; presentations of science in virtual formats; the Affordable Care Act turns 10.

To mark the 25th anniversary of the journal, each issue in 2020 will include an interview with a healthcare thought leader. For the March issue, which marks the 10th anniversary of the Affordable Care Act being signed into law, we turned to Representative Frank Pallone Jr, D-New Jersey, who played a key role in the law’s writing and passage.

Investigators tracked time to treatment for 3 types of cancer in states that expanded Medicaid coverage on January 1, 2014, comparing rates before and after the expansion. Patients with new diagnoses of invasive breast, colon, or lung cancers aged 40 to 64 years were included in the analysis.

Federal incentives fail to spur development of new drugs to treat rare diseases; alcohol-related deaths have risen steadily over the past several years; will CMS stop auto-enrolling low-income individuals in exchange health plans?

The second US Coronavirus death was reported in EvergreenHealth hospital in Kirkland, Washington; extended-release drugs were shown to cost almost $14 billion more than twice-a-day medications over a 5-year study; the Supreme Court plans to hear the third challenge to the Affordable Care Act in October.

As a whole, the public does not realize that certain health coverage benefits stem from the Affordable Care Act (ACA).

Writing for the panel, Judge David Sentelle said HHS Secretary Alex Azar ignored predictions that thousands of people would lose their healthcare coverage.

To mark the 25th anniversary of the journal, each issue in 2020 will include an interview with a healthcare thought leader. For the February issue, we turned to Gail Wilensky, PhD, an economist and senior fellow at Project HOPE.

The FDA gives marketing approval for a test that screens for Duchenne muscular dystrophy in newborns; acetaminophen is facing a possible statewide ban in California; the Supreme Court will not rush its decision on the Affordable Care Act.

The Supreme Court announced on January 17 it will hear a case regarding employers’ ability to limit access to free birth control under the Affordable Care Act. This marks the third instance the Court has looked at a case regarding applicability of the contraception mandate, but the first time with conservative Justices Neil Gorsuch and Brett Kavanaugh both on the bench.

Since 2016, racial and ethnic healthcare disparities have not improved; a new method of "reanimating" hearts from recently deceased donors for transplants is being tested; the new decade prompts concerns about an aging population.

Avalere Health broadcasted its annual Healthcare Industry Outlook for 2020 on January 9. The hour-long discussion included insights on some of the top healthcare topics predicted to have an impact in 2020. Although Medicare and drug pricing took center stage, artificial intelligence, the future of the Affordable Care Act, and 2020 presidential campaign platforms were among the subjects discussed.

AJMC® presents the results of our online poll of the top healthcare stories of 2019.

The FDA approved [fam-] trastuzumab deruxtecan-nxki, which will be marketed as Enhertu; preliminary CMS numbers show that 8.3 million people enrolled in coverage under the Affordable Care Act (ACA) from November 1 to December 17, about 2% fewer than last year; Sutter Health agreed to pay $575 million to settle claims of anticompetitive behavior brought by the California state attorney general as well as unions and employers.

A federal appeals court today struck down the individual mandate—the heart of the Affordable Care Act (ACA) that requires everyone to have health coverage and lays the groundwork for a risk pool that is more balanced between the sick and the healthy, the young and the old.

Open enrollment for ACA health plans is extended after glitches on Healthcare.gov; EPA watchdog found that the agency's health monitoring during Hurricane Harvey was lacking; Purdue Pharma splits ties with the lobbying organization PhRMA.

Governor Henry McMaster, a Republican, announced the waiver plan at an event in Greenville, South Carolina, with CMS Administrator Seema Verma by his side. Some observers see Verma’s promotion of Medicaid work rules in the face of court challenges as a key to her political survival in her feud with HHS Secretary Alex Azar.

Under the ACA, patients with HIV in Medicaid expansion states have greater access to care.

In a session at AMCP Nexus 2019, Melissa Andel, MPP, vice president of health policy, Applied Policy, covered the current state of health insurance coverage in the United States, major actions from the Trump administration impacting the Affordable Care Act (ACA), public sentiment around the ACA, and what stances presidential candidates have taken on healthcare.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

This week, the top managed care news included the average Affordable Care Act premiums falling 4%; the FDA approving a triple combination treatment for cystic fibrosis; House Republicans releasing part 1 of their healthcare plan.

HHS Secretary Alex Azar said his messaging about the Affordable Care Act (ACA) will be simple if the federal 5th Circuit Court of Appeals, in a decision that is expected any day now, sides with the administration in Texas vs Azar in finding the 2010 landmark health law unconstitutional. “Keep calm and carry on,” he said, as he and CMS Administrator Seema Verma released information about 2020 ACA premiums and health plan choices.

While the number of employers who reported they had self-insured at least one health plan had increased from 1999 to 2016, there was a sharp decrease by 38.7% in 2018, according to research from the Employee Benefit Research Institute.

According to a report from the US Census Bureau, the rising rate of the uninsured appears to be a result of a slump in Medicaid coverage. Health policy experts say the decline reflects efforts by the Trump administration to undermine the Affordable Care Act.

The nation’s community health centers, which serve patients who are largely low income and medically underserved, are facing a repeat of their 2017 funding crisis and are making contingency plans to lay off staff and reduce services, in case Congress does not pass a funding bill by September 30.

The Affordable Care Act’s reductions to Medicare Advantage plan payments were not significantly associated with healthcare access or affordability for enrollees.