Health Care Delivery

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.

While Republicans continue to look at dismantling President Obama's Affordable Care Act, they are also working on plans to extend subsidies temporarily to the millions of Americans who may lose the financial assistance should the Supreme Court rule in favor of the plaintiffs in King v. Burwell.

One point of concern among Justices Anthony Kennedy and Sonia Sotomayor during the oral arguments of King v. Burwell was the issue of unconstitutional coercion, and Timothy S. Jost, professor of law at Washington and Lee University School of Law, explains the main issue.

In its proposed fiscal year 2016 funding bill, the House Appropriations Committee is looking to defund the Affordable Care Act, block additional funding for patient-centered outcomes research, and terminate the Agency for Healthcare Research and Quality.

If the Supreme Court rules that individuals in states on the federal marketplace are ineligible for subsidies, the annual consumer premium contribution could increase $3300 in 2015, according to an analysis from Avalere Health.

Given that the subsidies in the federal exchange have helped to cover a lot of previously uninsured people, Chip Kahn, president and chief executive officer of the Federation of American Hospitals, remains encouraged the Supreme Court will "do the right thing."

The findings of inadequate access to providers and outdated information were no surprise to healthcare advocates. Many of the issues are addressed in a giant proposed rule issued by CMS in late May.

Another 2 companies that are using natural language processing and artificial intelligence in their efforts on direct-to-person health coaching.

The consensus that drug manufacturers are at fault for high prescription prices comes even though only half the respondents said they were taking medication themselves.

Although the introduction of new specialty drugs and increased investments into personal health data security, moderating forces will keep healthcare spending growth in check in 2016, according to a report from PwC's Health Research Institute.

Arkansas, Delaware, and Pennsylvania have all received tentative approval from HHS Secretary Sylvia Mathews Burwell to set up their own state-based insurance exchanges and move their residents off the federally facilitated marketplace.

Even though there hasn't been much public discussion from the Obama administration in regards to contingency plans should the Supreme Court rule in favor of the plaintiffs in King v. Burwell, there is likely much talk going on behind the scenes, explained Susan Dentzer, senior health policy adviser at the Robert Wood Johnson Foundation.