Health Care Delivery

This article describes provider networks and benefit design-including deductibles, cost-sharing, and maximum out-of-pocket limits-for oncology care in 2015 health insurance exchanges.

What we're reading, December 15, 2015: call centers overwhelmed by last-minute rush for health insurance enrollment; AstraZeneca exploring deal with Acerta Pharma; and despite near universal health insurance coverage in Massachusetts, patients have access issues.

Providers and payers came together to discuss challenges and share success stories as they adapt to the changing healthcare realm.

The advocacy affiliate of the American Cancer Society, the American Cancer Society Cancer Action Network, is working across the country to pass and implement strong oral chemotherapy fairness laws to help ensure cancer patients have access to the recommended course of treatment without added out-of-pocket costs based on how their drug is administered.

Addressing the financial burden of cancer treatment requires efforts at the policy, payer, and clinic level, and implementation of these strategies, in clinical practice, requires commitment from various stakeholders.

Most physicians consider telehealth a promising tool in improving patient access to primary care services, but only 15% use it in their practice.

Patients with chronic conditions, such as chronic obstructive pulmonary disease, often have high-cost health needs that make choosing a health plan difficult.

Consumer demand for engagement in health information technology is a vital aspect of achieving national health goals, but multiple barriers prevent this demand from being filled.

This week in managed care, an analysis found the penalty for being uninsured will exceed the cost of insurance for most Americans in 2016, thousands met for the annual meeting of the American Society of Hematology, and Horizon Blue Cross Blue Shield's OMNIA plan gets good news and bad news in New Jersey.

The National Coalition for Cancer Survivorship has submitted comments to CMS, providing feedback on the Merit-Based Incentive Payment System and Alternative Payment Models proposed by CMS as it transitions toward value-based reimbursement.

When considering how to rectify the rising prices of drugs, there are a number of interventions at multiple levels that can work to decrease costs to patients and the price of the drug, explained Yousuf Zafar, MD, MHS, associate professor in the Division of Medical Oncology at Duke Cancer Institute.

Health economist Austin Frakt, PhD, of Boston University, weighs in on Ben Carson’s healthcare plan to repeal the Affordable Care Act, implement personal savings accounts for all citizens, and reform Medicare and Medicaid.

What we're reading, December 11, 2015: CMS penalized hospitals for patient safety deficiences; MedPAC approved reducing Medicare Advantage plan reimbursement; and Kentuckians favor keeping Medicaid expansion.

Nearly 31% of Americans confirmed that they have postponed medical treatment for either themselves or a family member in 2015 because of the cost.

Electronic health record data can be used to predict patient absenteeism accurately. Predictive overbooking of missed appointments can significantly increase service utilization.

What we're reading, December 10, 2015: the Affordable Care Act has signed up 1 million new enrollees; Medicare patients spend more on oral cancer drugs than food each year; and the CDC found life expectancy remains at 79 years for the third year in a row.

A cancer survivor shares her experience and frustrations with cancer care costs and looks to changes within the healthcare system to improve the value of care in the future.

The 340B Drug Discount Program has rapidly expanded over the last few years and may be missing its original intent. Here are 3 possible steps that could enhance the program’s function and mirror Congress’ original intent to enhance access for the poor to essential medical services.

GOP presidential hopeful Ben Carson has presented his plan to overhaul the Affordable Care Act and replace it with a healthcare system that uses tax-sheltered personal savings accounts and reforms Medicare and Medicaid.

The Affordable Care Act's individual mandate will reach a point when the price of a bronze plan will cost less than paying the penalty of not being insured for many Americans.

What we're reading, December 9, 2015: the federal government recovered $200 million from state's whose health insurance exchanges faltered; drug cocktails are responsible for majority of drug overdose deaths in Massachusetts; and healthcare organizations are not confident in their ability to share patient data while protecting patient privacy.

Across the US, the states' rates of uninsured individuals can vary dramatically, and while all states have made gains in covering individuals, these 5 continue to have the highest uninsured rates.

A study of the prevalence and treatment of psoriasis in older Americans suggests the presence of economic and racial barriers.

What we're reading, December 8, 2015: Cigna remains committed to participation in Obamacare exchanges; Puerto Rico demands the US fix healthcare funding disparities; and fewer Americans struggle to pay medical bills.

After 5 years of low growth, CMS reports that national health spending grew 5.3% in 2014, which is still slower than most years prior to the implementation of the Affordable Care Act.