Health Care Delivery

A lawsuit filed Monday by 20 red states argues that the Affordable Care Act (ACA)’s individual mandate—and the law itself—is invalid; President Donald Trump brought up the issue of mental hospitals in a meeting with governors, and the administration said it is "actively exploring" ways to help states expand inpatient mental health treatment using Medicaid funds; an EPA center that distributes grants and fellowships to test the effects of chemical exposure on adults and children will be dissolved and consolidated within the agency.

A new policy report from the Urban Institute examining the effects of the Trump administration’s changes to the Affordable Care Act (ACA) finds that premiums will rise in ACA insurance plans and more people will be without insurance in certain states.

Integrating nonmedical social services with medical services is necessary for the United States healthcare system to address unmet social needs, according to a case study published in Health Affairs.

In response to Governor C.L. “Butch” Otter's executive order allowing Idaho insurers to offer insurance plans that do not comply with the Affordable Care Act, Blue Cross Idaho introduced Freedom Blue, 5 individual health insurance plans.

As the conversation surrounding healthcare spending in the United States persists, topics such as drug prices, increased annual spending, and government funding stay at the forefront. Here are 5 things about healthcare spending that are being currently discussed and addressed.

Shortly after Kentucky announced its new work requirements for the Medicaid program, a lawsuit was brought by residents against the government. Sara Rosenbaum, JD, the Harold and Jane Hirsh Professor of Health Law and Policy and founding chair of the Department of Health Policy at the Milken Institute School of Public Health, George Washington University, explains what other states looking to implement work requirements might face.

Premiums in federally facilitated Affordable Care Act Health Insurance Marketplaces are higher in geographic areas with more concentrated hospitals and physician practices and fewer insurers.

Born as part of the Affordable Care Act (ACA) in 2010, the controversial Independent Payment Advisory Board (IPAB) was eliminated last week as part of the Bipartisan Budget Act of 2018 without ever having been implemented. The IPAB sought to reign in Medicare spending if targets went over certain levels, but it had almost universal opposition from the healthcare and medical communities.

There was a reduced rate of uninsured patients at the time of diagnosis and a shift to earlier stage at time of diagnosis for patients with testicular cancer in states that adopted Medicaid expansion in 2014, according to findings presented at the 2018 Genitourinary Cancers Symposium.

Affordable Care Act (ACA) enrollment was stable in most places despite turmoil; National Institutes of Health research, opioid, and mental health funding see gains in budget deal, but ACA stabilization plan is missing.

Are Medicaid waivers meant to encourage able-bodied adults to work, or a return to poor laws of old? Or are they a means to get states that have not expanded Medicaid to expand? A diversity of viewpoints on these and other topics were on full display during Health Reform X.O: What Now, What Next?, the first session of AcademyHealth’s National Health Policy Conference.

A study released Monday found the Affordable Care Act (ACA) helped lower average out-of-pocket spending (OOP) overall, mainly because of reductions in spending among people eligible for the Medicaid expansion and cost-sharing and premium subsidies on the insurance exchanges. However, premium spending rose, mostly, because of large increases for those with higher incomes, said Anna Goldman, MD, MPA, one of the authors of the JAMA Internal Medicine study.

Maine Community Health Options is seeking $5.6 million from HHS, claiming the department failed to reimburse marketplace insurers for cost-sharing reductions for 2017. Under section 1402 of the Affordable Care Act, an insurer participating in the marketplace is required to offer CSR plans, and in return will be guaranteed reimbursement by the government.

Since the implementation of the Affordable Care Act (ACA), annual well visits among adolescents improved with visits increasing the most among Hispanic adolescents.

FDA approved 46 drugs in 2017, a 21-year high; pilot program tests using home care to reduce emergency department visits; a look at how increasing prices, not increased use of services, has caused American healthcare spending to grow so much faster than peer nations.

Patients with cancer may have more options for oral cancer medications, but high out-of-pocket costs still present a barrier to access, according to a new study in Journal of Clinical Oncology.

The spending bill featured a waiver to avoid Medicare cuts in 2018, before voters to go to the polls in the midterm elections.

Key drug approvals; alcohol cancer link.

Coverage of our peer-reviewed research and news reporting in the healthcare and mainstream press.

Finding cancer early is a key step to reducing cancer mortality, and a new study suggests that Medicaid expansion under the Affordable Care Act led to more and earlier cancer detection.

A pledge made to US Senator Susan Collins (R-ME) to support funding for cost-sharing reductions (CSRs) in exchange for her yes vote on the GOP tax bill fell apart Wednesday, apparently because House Speaker Paul Ryan refused to allow the funding to be included in this year’s spending package, slated to be voted on Friday.

AJMC®TV interviews let you catch up on what’s new and important about changes in healthcare, with insights from key decision makers—from the clinician, to the health plan leader, to the regulator. When every minute in your day matters, AJMC®TV interviews keep you informed. Access the video clips at ajmc.com/interviews.

A Commonwealth Fund analysis found that during the 3-year period, the uninsured rate for adults aged 19 to 64 dropped in all 50 states and the District of Colombia. The majority of states also saw less financial barriers to care and more coverage for children and low-income adults

The FDA plans to crackdown on alternative remedies; Senator Lamar Alexander, R-Tennessee, says his Obamacare insurer fix will be in the government funding bill; Alabama prepares to drop coverage for 7000 children.

Some states are considering implementing their own Obamacare individual mandates; a federal judge blocks a rule making it easier for employers to opt out of contraceptive coverage; Senator John McCain, R-Arizona, will miss tax bill vote, but the GOP should have enough votes.

Speaking at the National Comprehensive Cancer Network Oncology Policy Summit on Redefining Quality Measurement in Oncology, Ronald Walters, MD, MBA, MHA, MS, associate vice president of medical operations and informatics at The University of Texas MD Anderson Cancer Center, emphasized the need to focus on the patient’s preferences and values in cancer care delivery.

New legislation would suspend the Affordable Care Act’s medical device tax for 5 years; teenagers are now more likely to vape or use marijuana than smoke cigarettes; California women can access birth control at a pharmacist without a doctor’s prescription, but are unlikely to do so.

FDA is considering a faster approval process for medical devices; the American Clinical Laboratory Association is suing the federal government over a new reimbursement system; there are 2 Obamacare special enrollment periods that a greater-than-usual number of people could be eligible for.

Health officials are warning of an unusually harsh flu season; Ascension and Providence St. Joseph Health are in talks about a possible merger; and heavy traffic is expected as the final week of ACA sign-ups begins.

Coverage of our peer-reviewed research and news reporting in the healthcare and mainstream press.