Health Care Delivery

Earlier this year, the legislature laid the groundwork for Medicaid expansion to occur in 2016.

What we're reading, October 14, 2015: Jeb Bush offers a detailed proposal for his plan to replace parts of the Affordable Care Act, California places a cap on out-of-pocket costs for consumers, and people addicted to opioids can't get the treatment they need.

What we're reading on October 13, 2015: presidential hopeful Marco Rubio taps health policy expert Avik Roy to advise his campaign, Democrats will tangle over healthcare in first debate, and the US pays 3 times as much for medicine as Britain.

Although nearly 15 million Americans have obtained health coverage under the ACA, another 15.7 million are eligible but do not have coverage.

Changes in the healthcare marketplace are steadily pushing changes for physicians and specialty practices of all kinds. Blaming the 340B drug discount program is both misleading and unproductive.

What we're reading on October 12, 2015: health insurance marketplaces may have challenges keeping customers they already have, but in California, consumers leaving the state insurance exchange are gaining coverage elsewhere, and the government is increasingly pursuing cases of potentially unnecessary procedures.

Coverage expansions resulting from the Affordable Care Act have not had a negative financial effect on medical practices. Instead, primary care physicians reported increased collections and decreased visit volume, according to athenahealth

A multistakeholder approach to patient assistance programs was the topic of discussion at ACCC's first annual ICLIO meeting in Philadelphia.

An initiative by Horizon Blue Cross Blue Shield of New Jersey to implement integrated, value-based care on a wide scale has run into criticism from legislators who say it will bring financial harm to some safety net hospitals. A Senate hearing today concluded with a call for an investigation from the Attorney General into how the alliance was created.

Reimbursement remains a primary concern with the new immuno-oncology agents. Who pays and how do you ensure payment was fervently discussed by oncologists at the recent ICLIO meeting hosted by the Association of Community Cancer Centers.

A study reports that despite the steady growth in hospital-based palliative care programs, access is sketchy and is driven by geographic location and hospital ownership.

Patient access to innovation may be at risk as new payment models emerge in oncology.

The findings come as CMS is poised to finalize a rule to pay doctors to counsel patients about end-of-life treatment options.

Kevin W. Wildes, SJ, PhD, said that Pope Francis' call for access to healthcare leaves the specifics up to US leaders, as the church does not say that one system is better than another.

Healthcare networks around the country will be getting some financial help from HHS to improve quality of care, increase patient access to information, and reduce costs.

Eighty-six million US adults are at high risk of developing type 2 diabetes. Without prevention, there will be a drastic increase in the number of Americans who will develop type 2 diabetes.

A new report from The Commonwealth Fund has found similarities between premium costs for marketplace enrollees and those with employer plans. According to Are Marketplace Plans Affordable?, 60% of marketplace enrollees and 55% of individuals with employer plans pay either nothing or less than $125 a month for individual coverage.

More than $100 million in Affordable Care Act funding is being awarded to 17 national, regional, and state hospital associations and health system organizations to assist efforts to reduce hospital-acquired conditions and readmissions.

Many hoped the 2013 declaration by the American Medical Association that obesity is a disease would open the door for payer coverage of pharmacotherapy to treat it. While that did not happen right way, a new commentary in Evidence-Based Diabetes Management by Ted Kyle, RPh, MBA, and Fatima Cody Stanford, MD, MPH, MPA, outlines how the tide appears to be turning for coverage of evidence-based treatment.

The earlier you intervene with patients with mental health issues, the better the outcome for both the individual and the health system. Early intervention prevents pain and suffering and actually saves costs in the long run, said John Santopietro, MD, chief clinical officer of behavioral health at Carolinas HealthCare System.

Telehealth follow up consultations after a surgical operation have become preferred compared to in-person visits, according to 2 recent studies.

The problem in Kansas is the same as other states without Medicaid expansion: the ACA envisioned universal coverage, and funds to treat the uninsured are dwindling because it was expected that patients who are now in a "gap" would have insurance.

As enrollment in Medicare Advantage is expected to increase to a new all-time high for the sixth year in a row, CMS announced that Medicare Advantage premiums will remain stable in 2016.

The implementation of the Affordable Care Act (ACA) has reduced the number of uninsured Americans and created significant gains in health coverage among racial and ethnic minorities. However, the ability of Obamacare to reduce racial and ethnic disparities has been limited.

An analysis of the competitive landscape of the public health insurance exchanges as it has so far unfolded has revealed that despite challenges to date, the exchanges have been attracting new entrants.