Health Care Delivery

Both patients and hospitals in states that expanded Medicaid benefited from the wider eligibility.

A recent study analyzed screening procedures of community health centers and was able to quantify the screening gap for hepatitis C according to gender and race/ethnicity.

Tele-ICU has been part of a model of care that has tremendous potential to positively affect patients and their families; however, the concept of tele-ICU still faces a few challenges.

Rates of uninsured dropped faster than almost anywhere in the nation, but Kynect is part of "Obamacare," and the new Republican Governor Matt Bevin has vowed that it must go. Advocates have a lot of questions about how hard-to-target populations will be reached and whether grant funds will have to be repaid.

At the J P Morgan Healthcare Conference, Express Scripts' president Tim Wentworth shared the solutions being developed by the pharmacy benefit manager to improve patient access while reducing cost to payers.

What we're reading, January 12, 2016: 43,000 people will lose their Affordable Care Act tax credits for failing to file a 2014 tax return; Kentucky's new governor will dismantle the state's health insurance exchange; and deciding whether to get that medical test.

Affordable Care Act marketplace assisters played a vital role in helping millions of people gain access to healthcare coverage during the first 2 open enrollment periods, a study in Health Affairs finds.

What we're reading, January 11, 2016: drug shortages in the emergency departments have quadrupled since 2008; the government has done little to verify people enrolling after Obamacare deadline under special enrollment categories; and Pfizer increased the prices of 100 drugs.

The latest developments across the healthcare landscape and key upcoming conferences to attend.

Top managed care stories include Sanofi ending its deal to market Afrezza, Aetna cut ties with America's Health Insurance Plans, and a new study found bankruptcy looms large for cancer survivors.

Before the House of Representatives had even passed the bill that guts the Affordable Care Act, President Obama had already announced he would veto it. And now he has made good on that promise.

What we're reading, January 8, 2016: HHS releases report with full Obamacare enrollment information for all 50 states and the District of Columbia; the expansion of the biosimilars in 2016; and promising Ebola treatment found not effective.

The 3 core measures of acute myocardial infarction, congestive heart failure, and pneumonia are the leading causes of hospital admissions and expenditures. Our study sets the benchmark foundation for outcome evaluations of CMS’s value-based purchasing program and the Affordable Care Act.

Lydia Mitts, senior policy analyst at Families USA, explains the concept of a smarter deductible and the short-term impact of lower- and middle-income consumers switching plans and their understanding of their benefits.

What we're reading, January 7, 2016: the uninsured rate at the end of 2015 was essentially unchanged from the beginning of the year; CMS may start paying for some rehab for drug or alcohol addiction; and follow-up care plans after hospital discharge are often too difficult for patients to understand.

ACA marketplace consumer protections for 2016 will strengthen health plan network transparency and make it faster to get nonformulary drugs.

More than 5 years after the Affordable Care Act was passed, Republicans are sending a bill to unravel the healthcare law to the president's desk. President Obama has already vowed to veto the bill.

The country’s top insurance lobbying group is losing another big member as Aetna has decided not to renew its membership with America's Health Insurance Plans.

While the prevalence of problems paying medical bills may be greater in certain groups compared with others, almost anyone can experience difficulty paying medical bills, according to the results of a survey from Kaiser Family Foundation/New York Times.

What we're reading, January 5, 2016: A special report highlights how the working poor slip through the cracks of the Affordable Care Act; the FDA approved 51 drugs in 2015 with nearly half being first-in-class; and the Senate is expected to vote on President Obama's nomination for FDA commissioner next Tuesday.

Results from the ACRIN 6666 trial have found that breast cancer detection rate using ultrasonography is comparable with mammography.

What we're reading, January 4, 2016: health insurers offering free doctor's visits for some plans; some consumers find paying the Affordable Care Act penalty cheaper than buying insurance; and clinicians and patients are increasingly worried about opioid dangers.

Penny Mohr, MA, senior program officer for improving healthcare systems at the Patient-Centered Outcomes Research Institute, discusses comparative effectiveness research, healthcare disparities, and patient-centered care at the 20th annual international meeting of ISPOR.

Despite Congressional directives for 30 years to diversify clinical research, the number of studies that include minorities and the diversity of scientists being funded have not improved.

During the last month of 2015, The American Journal of Managed Care asked readers to choose what they thought was the top healthcare story from the year. Options included overall themes from the year and specific events.