Health Care Delivery

The number of Americans finding coverage through Medicaid expansion equals those who signed up for private insurance on the exchanges, according to new data. Montana has just passed legislation to become the 29th state to expand Medicaid.

The increased availability of urgent care centers, retail clinics, and telephone triage lines has not affected emergency department (ED) visits. In fact, three-fourths of emergency physicians report ED visits are going up.

As accountable care organizations work to deliver population health, patient satisfaction, and cost savings, the need to engage patients as partners in their own healthcare has never been more essential. The ACO and Emerging Healthcare Delivery Coalition, an initiative of The American Journal of Managed Care, gathered this week at the historic Hotel del Coronado in San Diego, California, to explore ways to make patients the starting points of healthcare, not just its recipients.

Patients at hospitals with high rates of skilled nursing facility discharge usually have poorer outcomes and higher downstream spending, according to researchers from Massachusetts Institute of Technology and Vanderbilt University.

Nearly half of the 17 insurance marketplaces set up by the states and the District under President Obama's health law are struggling financially. Many of the online exchanges are wrestling with surging costs and tepid enrollment numbers.

Patient access, supply chain, adherence, and comorbidities are only a few of the challenges associated with oral anticancer agents, which are included distributed by specialty pharmacies.

As hospitals and health systems work to develop population health strategies to better serve their communities and rein in the overall cost of care, behavioral health patients cannot be ignored.

The lackluster uptake of the special enrollment period for exchange coverage is driven, in part, because for most people individual mandate penalties are much lower than actual costs of coverage.

A one-minute look at managed care news during the week of April 27, 2015, including more good news for the much-anticipated PCSK9 inhibitors and growth in the individual insurance market enrollment.

In 2014, low- and moderate-income consumers were able to use premium subsidies to buy health coverage on Marketplaces under the Affordable Care Act. The individual health insurance market had been relatively flat for 3 years' prior.

Accessing patient information in a health information exchange system during the 30 days after hospital discharge reduced the odds of readmission, according to a study in the Journal of the American Medical Informatics Association.

Although the Supreme Court oral arguments of King v. Burwell mostly went the way people were expecting, there were a few surprises, said Thomas P. Miller, JD, resident fellow at the American Enterprise Institute, who was able to sit in the courtroom the day of the arguments.

Although practices saw a decrease in patient visits during the 2 years after electronic health record implementation, they reported an increase in revenue during that same time period, according to a study in the Journal of the American Medical Informatics Association.

House Republicans say that Medicaid takes up too much of the state's budget for them not to have more say in who receives it. They also included budget language calling for Medicaid officials to ask CMS to allow healthcare savings accounts for almost all beneficiaries.

Industry experts at the National Association for Healthcare Quality's National Quality Summit highlighted improving care through successful care transitions.

Studies have shown that embedding behavioral health services into the primary care practice produces better health outcomes for patients with diabetes, while reducing indications of depression. The challenge is figuring out how to make the transition to new payment models that reward such care.

A study of the use of patient portals among older Americans found clear disparities in the registration and use of this technology. The results were published in the Journal of the Americans Medical Informatics Association.

In a new survey, more than half of self-identified Republicans said they didn't think the Affordable Care Act is increasing the number of people with health insurance, with a fifth of respondents saying it has actually reduced the number of people with coverage.

Medicaid managed care is expanding throughout the United States. Iowa is going through a request-for-proposal process, and Kentucky is rebidding its contracts after switching over to managed care in 2011.

The federal government's review of how much money it spends to help pay for the hospital costs of low-income people in Tennessee and other states that didn't expand Medicaid feels like a threat to Governor Bill Haslam.

Satisfaction with the Health Insurance Marketplace exchange enrollment process among new enrollees has significantly increased from 2014.

Patients with multiple long-term health conditions are more likely to report poorer experiences in primary care than those with fewer health problems, according to recent findings by researchers from the University of Cambridge and RAND Europe.

States increasingly use managed care for Medicaid enrollees, yet evidence of its impact on healthcare outcomes is mixed. This research studies county-level Medicaid managed care penetration and healthcare outcomes among nonelderly disabled and nondisabled enrollees.

Researchers from the University of Washington examined drinking patterns down to the county level, and found wide disparities within state borders. This suggests that solutions to problem drinking must be found locally.

Avalere, partnering with the National Comprehensive Care Network, surveyed 20 cancer centers and found that 75% of respondents were covered by at least "some" of the exchange plans in their state.