Health Care Delivery

New targeted therapies reduce waste and identify patients that will benefit most, but their high price tags have left the healthcare industry scrambling to figure out how to pay for these treatments and cures.

The Academy of Managed Care Pharmacy Annual Meeting kicked off on March 28, 2017, in Denver, Colorado, with a look at the specialty pharmaceutical pipeline with Aimee Tharaldson, PharmD, senior clinical consultant for emerging therapeutics at Express Scripts.

Healthcare consulting is a growing industry touching each of the stakeholders involved in healthcare, and these consultants are playing an increasingly significant role in the United States healthcare system.

This supplement showcases the winning papers and case studies from the PAN Challenge, which aimed to stimulate a dialogue on ways to reduce or eliminate the barriers and disparities that Medicare and ACA enrollees face in obtaining medications to treat life-threatening, chronic, and rare diseases.

How peer-to-peer, community support programs can educate and empower patients to become more adherent to treatments, which will improve outcomes and reduce healthcare costs.

Questions about cost-sharing subsidies, risk corridors, and what to do about red state Medicaid expansion will confront the Trump administration no matter how much the president wants to move on to other issues.

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.

After weeks of negotiations and last-minute drama, the House GOP has pulled its Obamacare replacement bill after it became clear that there were not enough votes to pass it.

This week, the top stories in managed care included last-minute changes to Republicans' bill to repeal the Affordable Care Act; a lack of votes to pass the GOP health bill; and promising study results on PCSK9 inhibitors and SGLT2 inhibitors.

Debate on the House floor covered familiar ground: Republicans called for an end to the individual mandate and decried rising premiums and fewer insurers on the exchanges, while Democrats blasted the proposed cuts to Medicaid. The late change to cut essential health benefits cost House leaders a key moderate vote.

As House Speaker Paul Ryan, R-Wisconsin, and President Donald Trump endeavored to round up enough Republican votes to pass the American Health Care Act this week, a major sticking point for some reluctant GOP legislators was the inclusion of the Affordable Care Act’s essential health benefits in the replacement bill. Reports indicate that the essential health benefits requirement will be cut from the bill that will go to the House for a vote today.

House leaders and White House negotiators are unable to break the impasse created by conservatives, who say the bill does not sufficiently unravel Obamacare, and moderates who worry about lack of coverage for constituents.

At the 22nd Annual Conference of the National Comprehensive Cancer Network, held March 23-25, 2017, in Orlando, FL, policy researchers with interest in cancer care disparities discussed the source of existing disparities and how they can be successfully addressed.

House leaders are balancing the need to win votes from conservative members with the need to not put moderate members at risk.

As part of Republicans’ fast and furious push to repeal the Affordable Care Act, there is a vote scheduled today in the House of Representatives on the American Health Care Act. However, there have been serious doubts in the days leading up to the Thursday vote that there were enough votes in the House to pass the bill.

The report, which provides an update on all the monumental changes witnessed by the field of oncology over the last year, highlights 3 key achievements: new investments in science and insurance coverage, payment models that emphasize quality, and rapid-learning healthcare systems.

The Republican healthcare law repeals several provisions in former President Barack Obama’s health law; however, while the GOP's American Health Care Act does provide financial assistance, similar to the Affordable Care Act (ACA), Americans will find that those dollars don’t go as far as they did under the ACA.

The increased emphasis that the Affordable Care Act and Medicare accountable care organizations (ACOs) placed on prevention is important in reducing the high cost of older patients, especially as the baby boomer generation reached retirement age, explained Mariétou Ouayogodé, PhD, post-doctoral fellow at The Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth.

Difficulty in making pricing and reimbursement decisions for rare diseases has prevented patients from having universal access to new medicines despite increased investment in their research and development. In Europe, a group has proposed 9 principles to guide value assessment, pricing, and funding.

HHS Secretary Tom Price, MD, continued to downplay the Congressional Budget Office’s report on the GOP healthcare bill, promoted how the plan gives Americans more choice, and clarified an earlier statement made about the financial health of patients during a CNN town hall moderated by Wolf Blitzer and Dana Bash.

Affordable Care Act exchange enrollees in California and Colorado reported significant improvements in access to care and fewer barriers to receiving care due to costs.