Health Care Delivery

Unaccounted for social and clinical characteristics of a hospital's patient population explain nearly half of the difference in readmission rates between the best and the worst performing hospitals when it comes to Medicare penalties for hospital readmission rates.

Healthcare policy experts gathered in Washington, DC, to discuss access, cost, and the definition of value in oncology care.

Healthcare practitioners are well aware that the rising cost of medical advances may affect their ability to deliver great care to all their patients, but there are ways they can address the issue, said Joseph Alvarnas, MD, the editor-in-chief of Evidence-Based Oncology.

People with insurance have significantly higher probabilities of being diagnosed for diabetes, hypercholesterolemia, and hypertension than people without insurance.

The top stories in managed care this week include value-based pricing of the new PCSK9 inhibitors, CMS unveiled a new health equity plan for Medicare, and the American Medical Association released analyses on proposed health insurance mergers.

Creating a statement that mental health and physical health have parity is important for achieving outcomes in patients with chronic illnesses, said Trishan Panch, MBBS, MPH, chief medical officer at Wellframe.

House Republicans won a minor victory in a new lawsuit against the Obama administration for the legality of spending money from the Treasury for health insurers under the Affordable Care Act. Arguments will be heard this fall.

Kim Thiboldeaux, chief executive officer of the Cancer Support Community, discusses the importance of providing strong community support, the misconceptions of clinical trials, and creating a tailored care plan.

At the end of CMS' comment period, the American Society of Clinical Oncology submitted its comments and recommendations for the proposed changes.

The California Public Employees' Retirement System saved $7 million on screening colonoscopies during a 2-year period following implementation of reference pricing.

CMS has released a new plan to address health equity in Medicare, which includes 6 priority areas aimed at reducing health disparities over the next 4 years.

With the comment period ending today, the proposed CMS cuts to radiation oncology reimbursement rates might have a substantial impact on community treatment centers.

For individuals who have not made the sort of risk-averse decisions in their lives that lead to better jobs and wealth accumulation, making treatment decisions after a cancer diagnosis can be very difficult, said Amy Davidoff, PhD, MS, senior research scientist in public health at the Yale School of Public Health

An analysis of Medicare Advantage (MA) plan market shares finds little competition in counties across the nation, according to a report published by The Commonwealth Fund.

Predictive modeling determined that the needle exchange in Washington, DC, prevented 120 new cases of HIV in 2 years, according to researchers.

HHS is seeking new protections for vulnerable populations to protect them from discrimination and ensure they have equal access to healthcare and health coverage.

The difference between "heart age" and chronological age indicates risk of events like heart attacks and strokes, and could motivate younger patients to improve unhealthy lifestyles.

Leah Binder, president and CEO of The Leapfrog Group, will be the keynote speaker at the upcoming meeting of the ACO and Emerging Healthcare Delivery Coalition, to be held October 15-16, 2015, in Palm Harbor, Florida. The Coalition, an initiative of The American Journal of Managed Care, brings together stakeholders from across healthcare to share ideas for navigating the changing reimbursement landscape.

CMS is making available grant funding for 100 organizations to provide enrollment assistance during the third open enrollment period under the Affordable Care Act.

Personalized telephone counseling and tailored educational materials can improve colonoscopy rates among at-risk family members of patients with colorectal cancer.

Awareness of the ACA has brought out more recipients eligible for Medicaid than the state knew it had.

The Cancer Prevention and Ethics Committees of the American Society of Clinical Oncology have made several recommendations that address genetic and genomic testing policies for cancer risk assessment.

The ruling will most likely be appealed by the government. The ACA requires coverage for contraception as a preventive service.

Only about one-fourth of all patients with behavioral health issues are diagnosed by a primary care provider and receive the appropriate treatment, said Paul Ciechanowski, MD, MPH.

Research from The Commonwealth Fund found little indication that risk segmentation is causing adverse effects in the insurance market either in coverage sold on the exchanges and coverage sold off the exchanges.