Health Care Delivery

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.

How counties, cities, and schools are saving money by importing drugs for employees; insurers are finally turning a profit on their Obamacare plans; new report projects the number of Americans with Alzheimer's disease will more than double by 2060.

House Speaker Paul Ryan, R-Wisconsin, is eyeing spending cuts to Medicare and Medicaid; Louisiana's Medicaid program reported lower-than-expected spending and a potential surplus; ACA enrollment continues to climb, but expected to fall short of 2017 due to shorter enrollment period.

The rate of healthcare spending in the United States slowed down last year to levels previously seen between 2008-2015, driven by much slower growth in spending for retail prescription drugs, as well as hospital care and physician and clinical services. Private payers, Medicaid, and Medicare­ also saw lower rates of spending growth.

Senator Susan Collins, R-Maine, makes her tax bill vote contingent on more Obamacare funding; some states are setting up programs to recycle leftover drugs; and pregnant women deal with medication uncertainty.

Researchers at Duke University found there is substantial room for improvement in providing consumers with ready access to healthcare prices online.

Republican leaders begin work Monday reconciling the differences in the Senate and House tax legislation, hoping to send a final bill to President Trump before Christmas. Senate Republicans passed the bill by 51-49 just before 2 am on Saturday.

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