Health Care Delivery

CMS has begun to implement risk adjustment and reinsurance programs, 2 premium stabilization programs of the Affordable Care Act. The report highlighted the estimated reinsurance payments issuer in addition to summary level information on the programs, which helps to keep premiums affordable as well as various coverage options available to consumers.

Despite concerns that Medicare Advantage payment reductions included in the Affordable Care Act would lead to a decline in enrollment, the number and share of beneficiaries enrolling in Medicare Advantage has only continue to climb since the health reform law was enacted.

In an effort to better examine and understand the implementation and effects of the Affordable Care Act, researchers from the Urban Institute found that nongroup health insurance premiums in insurance marketplaces were lower than expected.

Police officers in the United States are woefully untrained to approach individuals with behavioral health issues, according to a new analysis from Washington Post. In the first 6 months of 2015, police have shot and killed 123 people in the throes of mental or emotional crisis.

Although GOP presidential hopefuls are all campaigning on promises to repeal and replace President Obama's Affordable Care Act (ACA), the last real chance to repeal may have been the 2012 election, according to Avik Roy, senior fellow at the Manhattan Institute.

Shortly after the Supreme Court ruled in favor of the government in King v. Burwell, President Barack Obama triumphantly claimed that "Affordable Care Act is here to stay." However, the truth is that GOP presidential hopefuls have no intention of letting the law stand.

This week the Supreme Court ruled in favor of the government in King v. Burwell, preserving access to healthcare subsidies for millions of Americans, and the high cost of cancer drug was in the spotlight.

The King v. Burwell decision to uphold subsidies on the federal marketplace is a win for patients who might have lost their mental health insurance coverage.

With the Supreme Court ruling in King v. Burwell keeping subsidies available to consumers on the federally facilitated marketplace, healthcare associations, insurers, health plans, and other stakeholders have been voicing their support and relief at the 6-3 ruling.

Although Kentucky and Arkansas went about expanding Medicaid coverage in 2 different ways, they shared common strategies that led to their success.

More than half of physicians in a nationwide survey are willing to see their patients over video, claiming the work-life balance to be the most common reason for the potential change in health system referrals.

The Core Quality Measures Collaborative Workgroup, initiated by AHIP and payer organizations, seeks to reduce, refine, and relate the healthcare delivery process.

The Supreme Court may have kept subsidies available to all Americans regardless of whether their state has set up its own exchange, but some people still refuse to purchase coverage, and they're perfectly happy remaining uninsured.

In a triumphant win for President Obama's Affordable Care Act and millions of Americans, the Supreme Court of the United States ruled against the plaintiffs in the case King v. Burwell and upheld the availability of subsidies for individuals on the federally facilitated marketplace.

A new study summarizing network size by physician, not just hospital participation, determined that 41% of networks on the marketplaces can be considered small or x-small and contain just 25% or less of office-based physicians in the area.

There have been numerous attempts to repeal part or all of the Affordable Care Act since it became law, and the Congressional Budget Office admits its estimates on the effect of repealing the law are all subject to "substantial uncertainty."

A researcher from the University of Missouri and her team, studied the impact of closure of a large, safety-net agency on it's clients and on smaller agencies to which the clients were referred.

During the first year of health coverage expansion under the Affordable Care Act, many primary care providers said the number of patients they saw increased, but reported no compromise in quality of care provided, according to a study from the Kaiser Family Foundation and The Commonwealth Fund.

There are 2 strategies for addressing primary medication nonadherence that have seen success, according to Lauren Harner, JD, senior manager for policy at PhRMA.

A new report from the Kaiser Family Foundation analyzed the impact of gaining health insurance through the Affordable Care Act for low-income families.

This week 3 states received approval to set up their own state exchanges in the even the Supreme Court removes subsidies in the federally facilitated marketplace, and the deadline passed for stakeholders to respond to CMS' proposed rules for mental health parity in Medicaid managed care.

Home healthcare transition from hospitals for diabetic Medicare home healthcare beneficiaries can be improved by identifying risk factors for 30-day readmissions due to ambulatory care—sensitive conditions.

Although there will be changes in the marketplace if the Supreme Court decision makes residents in states using HealthCare.gov ineligible for subsidies, it won't be anything that is irreversible, according to Thomas P. Miller, JD, resident fellow at the American Enterprise Institute.

The discussion about managed care comes as lawmakers continue to ignore pleas to expand Medicaid to 191,000 uninsured residents in Missouri. A White House report released earlier this month made a case for expansion but was largely ignored by expansion opponents.

Despite the increased use of breast-conserving therapy among women with early-stage breast cancer, many women continue to undergo mastectomy, according to a study from researchers at the University of Texas MD Anderson Cancer Center in Houston published in JAMA Surgery.