Health Care Delivery

ACA marketplace consumer protections for 2016 will strengthen health plan network transparency and make it faster to get nonformulary drugs.

More than 5 years after the Affordable Care Act was passed, Republicans are sending a bill to unravel the healthcare law to the president's desk. President Obama has already vowed to veto the bill.

The country’s top insurance lobbying group is losing another big member as Aetna has decided not to renew its membership with America's Health Insurance Plans.

While the prevalence of problems paying medical bills may be greater in certain groups compared with others, almost anyone can experience difficulty paying medical bills, according to the results of a survey from Kaiser Family Foundation/New York Times.

What we're reading, January 5, 2016: A special report highlights how the working poor slip through the cracks of the Affordable Care Act; the FDA approved 51 drugs in 2015 with nearly half being first-in-class; and the Senate is expected to vote on President Obama's nomination for FDA commissioner next Tuesday.

Results from the ACRIN 6666 trial have found that breast cancer detection rate using ultrasonography is comparable with mammography.

What we're reading, January 4, 2016: health insurers offering free doctor's visits for some plans; some consumers find paying the Affordable Care Act penalty cheaper than buying insurance; and clinicians and patients are increasingly worried about opioid dangers.

Penny Mohr, MA, senior program officer for improving healthcare systems at the Patient-Centered Outcomes Research Institute, discusses comparative effectiveness research, healthcare disparities, and patient-centered care at the 20th annual international meeting of ISPOR.

Despite Congressional directives for 30 years to diversify clinical research, the number of studies that include minorities and the diversity of scientists being funded have not improved.

During the last month of 2015, The American Journal of Managed Care asked readers to choose what they thought was the top healthcare story from the year. Options included overall themes from the year and specific events.

What we're reading, January 1, 2016: key healthcare legal battles in 2016; study looks at the safety and outcomes of giving birth outside of the hospital; and a tool helps providers better understand the costs they incur.

In 2014, Forbes said the Massachusetts Health Connector was the worst exchange in the nation.

Studies that provided updates on new drug trials, sessions on value-based care, and the cost of healthcare, were most popular among readers of The American Journal of Managed Care.

What we're reading, December 30, 2015: most commonly used generic drugs were cheaper at the end of 2015, meanwhile the FDA has a huge backlog of generic drug applications, and few states are expected to expand Medicaid in 2016.

Puerto Rico’s community health centers face grave challenges because of a lack of funding.

How promoting the penalties of the individual mandates changes the sign-up mix, changing attitudes on women's pelvic health, and the challenges that await Louisiana's new governor as he plans to expand Medicaid.

Patient awareness and educational support can improve their attitude as well as prepare them to make better informed decisions on clinical trial participation, a new study has found.

What we're reading, December 28, 2015: patients fight for Medicaid coverage of expensive hepatitis C treatment, Express Scripts develops programs to protect insurer's from pricey new drugs, and Republicans divided over Medicaid expansion.

A new study published by the American Cancer Society found that younger colorectal cancer survivors end up spending over $8500 annually in medical expenses and they also experience significantly greater loss of productivity compared with individuals without cancer.

Study finds healthcare access was of paramount importance to people with chronic conditions and their caregivers.

Historically, the biggest barrier to enrolling diverse populations in clinical trials has been a lack of establishing trusting relationships between researchers and communities and their residents, explained C. Daniel Mullins, PhD, professor in the Pharmaceutical Health Services Research Department at the University of Maryland School of Pharmacy.

Top 10 videos from The American Journal of Managed Care's Summit and Insight programs.

What we're reading, December 24, 2015: more than half of Affordable Care Act co-ops will be closed by the end of 2015, but this could have been avoided; 5 senators are pressing CMS for information on containing drug costs; and a task force does not recommend screening all teens and children for high cholesterol.

The new rule has been issued just as states are cracking down on the practice of balance billing patients who take steps to use in-network hospitals, only to be balanced billed anyway if they are seen by a provider not on their health plan.

With the Affordable Care Act endangered during the first half of 2015, many popular newsroom stories concerned President Obama's signature legislation.