Health Care Delivery

What we're reading, July 6, 2016: the Department of Veterans Affairs has made progress, but still has a long way to go; court upholds 6-month delay for biosimilars; and Apple promotes organ donation with iPhone app.

Connecticut Insurance Commissioner Katharine L. Wade moved to protect existing policyholders after HealthyCT learned June 30, 2016, it would have to pay CMS $13.4 million under the ACA Risk Adjustment program, which has been heavily criticized.

What we're reading, July 5, 2016: South Carolina's Obamacare health insurance exchange is close to collapse; hepatitis C virus treatment restrictions are being slowly lifted; and a special feature on what foods are healthy.

This week, the top stories in managed care include the largest healthcare fraud takedown, one successful accountable care organization imparted its secrets, and a report identifies pharmacy trends in the public health exchanges.

In the most recent Web-based session of The American Journal of Managed Care’s ACO & Emerging Healthcare Delivery Coalition, speakers examined 3 practice transformation models.

What we're reading, July 4, 2016: a hospital is offering free housing to get super-utilizers out of the emergency room; campaigns for patients to gain access to stem cell treatments are gaining momentum; and why hospital/physician integration and consolidation probably won't lower costs.

In the last 5 years urgent care has seen a rise in popularity. Here are 5 facts about urgent care clinics.

What we're reading, June 30, 2016: one doctor makes the case for the FDA moving away from a simple approval/no approval system; Massachusetts and Gilead come to an agreement over hepatitis C drug rebates; and Georgia considers Medicaid expansion.

Coverage from Patient-Centered Diabetes Care, April 7-8, 2016. Presented by The American Journal of Managed Care and Joslin Diabetes Center.

Coverage from Patient-Centered Diabetes Care, April 7-8, 2016. Presented by The American Journal of Managed Care and Joslin Diabetes Center.

Improved health literacy will help consumers understand plans and benefits so that they can make better decisions and Florida Blue has focused on experiential marketing where customers are engaged in community events, outreach programs, and educational sessions, explained Anne Jessup, senior director of digital channels at Florida Blue.

The rising cost of drugs is a cause for concern among various stakeholders in healthcare, some of who worry that staying on the current trajectory will “break the bank,” said panelists during a session at the ISPOR Annual Meeting.

What we're reading, June 27, 2016: Blue Cross and Blue Shield of Minnesota is leaving the individual market; out-of-pocket costs for hospital visits grew 37% in 5 years; and a growing number of millennials are becoming caregivers for loved ones.

The American Enterprise Institute (AEI) released its own plan for making improvements to the healthcare system, which included ideas such as premium support for Medicare, explained Joe Antos, PhD, the Wilson H. Taylor Scholar in Health Care and Retirement Policy at AEI.

Prescription drug spending between 2014 and 2015 increased at a much higher rate among health exchange plans compared with commercial plans, Medicare, and Medicaid plans. Express Scripts highlighted 3 select trends that are having the biggest impact on plans.

This week in managed care, the top stories included House Republicans' new plan to repeal and replace the Affordable Care Act, new funding from HHS to help small practices follow the Medicare Access and CHIP Reauthorization Act, and the Supreme Court rules on a patent lawsuit that impacts pharmaceutical companies.

Despite recommendations and the passage of legislation, there is little evidence that the quality of behavioral health has improved significantly over the last 10 years in the United States.

What we're reading, June 24, 2016: Britain's decision to leave the European Union will impact drug regulation; Supreme Court decision derails California proposal to allow illegal immigrants to buy health insurance; and lawmakers look to reduce exclusivity period for biologics.

An appellate panel found that a group of hospitals could not have information that Horizon withheld during discovery in 2 breach of contract suits related to its OMNIA tiered health plan. An attorney for 1 group of those hospitals said it will appeal because consumers and providers need to know how the tiered health network was created.

House Speaker Paul Ryan said the policy outline represents the first consensus among his conference to replace "Obamacare," which the document says has not worked because it has limited choice, increased consumer costs, and created new regulatory burdens for employers.