Health Care Delivery

The top stories in managed care this week include findings on cancer survival disparities, CVS Health claimed drug spending growth slowed in 2015, and Horizon Blue Cross Blue Shield of New Jersey's OMNIA plan is interfering with existing patient-centered medical homes.

In the years since the passage of the ACA, the partisan divide over "Obamacare" remains as sharp as ever. The Kaiser poll also found that reaction to universal health coverage shifts depending on what it is called.

There are multiple barriers to accessing innovative oncology care from the design of healthcare benefits to a patient’s position on the federal poverty level, explained Daniel J. Klein, president and CEO of the Patient Access Network (PAN) Foundation.

What we're reading, February 25, 2016: the government will require proof of eligibility for enrollment in special sign-up periods under the Affordable Care Act (ACA); this year's flu vaccine is more effective; and 6 states are suing the Obama administration over an ACA fee.

What we're reading: drug makers are not reporting complete information about side effects; Johnson & Johnson will pay $72 million to the family of a woman who blamed her ovarian cancer on talcum powder; and Maine and Utah make new attempts at expanding Medicaid.

A survey of 54 hospitals from 6 major metropolitan areas found that consumers are still encountering difficulties when trying to obtain price estimates for routine hospital procedures.

When patients select their care delivery sites based solely on price, they may misjudge their options, said Chet Burrell, president and CEO of CareFirst BlueCross BlueShield.

A new report by the American Cancer Society points to disparities in cancer survival between whites and blacks for certain cancers, although the reasons for these differences remain unconfirmed.

What we're reading, February 23, 2016: drug spending for CVS health plans slowed from 11.8% to 5%; CDC Director Tom Frieden, MD, MPH, talks Zika virus; and an investigation into the HealthCare.gov launch found widespread mismanagement.

To improve access for beneficiaries, CMS has proposed a plan to increase the availability of preferred cost-sharing pharmacies in Medicare.

CMS proposes increasing payments to Medicare Advantage plans by an average of 1.35% in 2017 in contrast to proposed cuts in recent years.

Adult obesity increased to 28% of the US population in 2015 and the diabetes rate also climbed to 11.4%. Adults who are obese are 4.7 times more likely to be diabetic compared with adults with a normal weight

For independent primary practices considering transitioning into a medical home, substantial costs to make the transition may outweigh the benefits, according to a recent RAND study.

Two studies presented at the ongoing 2016 Multidisciplinary Head and Neck Cancer Symposium report on financial hurdles faced by patients diagnosed with head and neck cancer that result in lifestyle modifications, advanced disease, and worse outcomes.

Population health, healthcare value, innovations in healthcare, cost of care-these were just some of the topics discussed at the meeting.

What we're reading, February 19, 2016: long-term hospice care is weighing on Medicare; both the pope and the World Health Organization suggest women in Zika infected countries have access to contraception; and Texas health official steps down after co-authoring study on Planned Parenthood.

While primary care physicians are incorporating more nurse practitioners and physicians' assistants into patient care teams, there is a lack of incorporation of other healthcare professionals, such as behavioral specialists, psychiatrists, and pharmacists.

Robert Nesse, MD, the senior director of Policy and Payment Reform at Mayo Clinic, discussed the impact of healthcare consolidation for consumers, whether or not they are aware of it, and how the government will respond to this consolidation.

Employers can encounter complications with benefit design approaches when it comes to those patients for whom traditional, less-expensive drugs are ineffective, or for those who prefer to have the drugs administered differently, explained Cheryl Larson, BA, vice president of the Midwest Business Group on Health.

How beWellnm, New Mexico's state-based insurance exchange, has defined its role and how it is helping individuals since the implementation of the Affordable Care Act, according to Amy Dowd, CEO of beWellnm.

A Task Force composed of gastroenterology specialists, with a special interest in colorectal cancer, has released updated recommendations urging post-operative colonoscopy instead of endoscopy to improve survival.

Individuals with more than one diagnosis are more likely to report to a primary care physician than to a subspecialty physician.

What we're reading, February 16, 2016: Affordable Care Act enrollment for 2016 is far below initial estimates; healthcare record hacks increased 11,000% in 2015; and genetic testing hasn't seen wide adoption among consumers.

A noninvasive colorectal cancer screening test manufactured by Exact Sciences, which received CMS coverage within months of its FDA approval, is not included under Humana’s coverage policy

Looking at trends in economic growth, healthcare costs, and employment, researchers find that the Affordable Care Act has acted as an economic stimulus.

What we're reading, February 15, 2016: despite cuts to the program, enrollment in Medicare Advantage is up 50% over 5 years; orphan drug designations from the FDA up 22% in 2015; and Zika virus infections on the rise in Puerto Rico.

Justice Antonin Scalia has died at the age of 79. The absence of the conservative justice from the Supreme Court bench has set off a political firestorm and could have repercussions for upcoming healthcare cases.

In spite of the Affordable Care Act's contraceptive coverage guarantee, there have been some obstacles in ensuring that privately insured women do not encounter out-of-pocket cost.

A study published in Cancer Epidemiology, Biomarkers & Prevention has identified geographic and ethnic factors as an important determinant of vaccinating against the human papillomavirus.

Every year, health policy wonks get into the loving spirit of Valentine’s Day with poetry, puns, and more on Twitter using the popular hashtag #HealthPolicyValentines. We round up some of the best.