Health Care Delivery

Enrollment in health plans sold in the new health insurance marketplaces under the healthcare reform law appears to be lagging far behind targets.

In states refusing to expand Medicaid programs, many low-income individuals are likely to face even more difficulties in receiving care as a subsidy that assisted safety net hospitals is reduced under the Affordable Care Act (ACA).

With increasing numbers of Americans gaining insurance under the Affordable Care Act, many experts are worried about the looming physician shortage.

For all the current focus on Obamacare lurching into its infancy, 50-year-old Medicare is also undergoing profound and disruptive change as Congress struggles with soaring medical bills and a growing senior population.

A government subsidy, little known outside health policy circles but critical to the hospitals' survival, is being sharply reduced under the new health law.

The agency tasked with implementing the president's healthcare law said Thursday it had uncovered new stresses further downstream in the system that revealed the need for a fresh look at the back-end capacity needs of the online healthcare portal.

Bowing to intense criticism, President Barack Obama apologized to Americans who are losing health insurance plans he repeatedly said they could keep and pledged to find fixes that might allow people to keep their coverage.

Millions of people could qualify for federal subsidies that will pay the entire monthly cost of some health care plans being offered in the online marketplaces set up under President Obama's health care law, a surprising figure that has not garnered much attention, in part because the zero-premium plans come with serious trade-offs.

A recent analysis shows that people are electing to enroll in Medicaid instead of buying private health insurance on the 15 state-based health insurance exchanges. It's projected that if this trend continues, there will not be enough healthy young people buying health insurance to make the system work.

The challenges in reforming healthcare seemingly continue to increase.

One month into open enrollment on the health insurance exchanges, HHS Secretary Kathleen Sebelius apologized for what she described as a "miserably frustrating experience for way too many Americans" on the federal online marketplace known as HealthCare.gov.

After focusing for weeks on the technical failures of President Obama's health insurance website, Republicans on Tuesday broadened their criticism of the health care law, pointing to Americans whose health plans have been terminated because they do not meet the law's new coverage requirements.

Consumers who buy a health insurance policy good for only 364 days might save hundreds of dollars in premiums, but they could also find themselves without important benefits and charged a penalty for not having insurance next year.

Under PPACA, in every interaction between patients, doctors, insurers, manufacturers and researchers, the incentive to control costs and provide better service is replaced with the decree to do so.

The premiums for Medicare Part B will remain flat in 2014 and seniors have saved $8.3 billion on Part D prescriptions since the Affordable Care Act was enacted in 2010, the Department of Health and Human Services announced Monday.

Amid the havoc of a healthcare insurance exchange website overwhelmed with problems, many aired concerns as to whether the individual mandate penalty would be delayed.In addition to President Obama calling in reinforcements to address exchange technology problems, the administration announced Wednesday that it would extend the consumer enrollment deadline until March 31, 2014.

The Obama administration said Wednesday that it would delay imposing penalties for six weeks on some consumers who might have been caught in a sticky timing problem for enrolling in coverage through the health law's new insurance marketplaces.

Data now obtainable from HealthCare.gov show there are 78,437 variations of health plans throughout the 36 states covered under the federal government's troubled web site, ranging from a bare-bones policy going for $81.34 a month in Kansas for a 27-year-old, up to a so-called gold family plan with an HMO in Virginia costing $6,494.54 a month.

Millions of Americans may still log on to discover that they aren't eligible for any health coverage at all. And that won't be due to any technical glitch. It's because their state has.

We discuss our concerns about tying physician performance to CG-CAHPS scores and suggest an alternative approach to facilitate translation of service excellence into clinical practice.

By 2020, an estimated 85% of Medicaid beneficiaries are expected to be enrolled in a managed care organization a significant increase from the nearly 50% that are currently enrolled.

The American Journal of Pharmacy Benefits (AJPB) and the Pharmacy Benefit Management Institute (PBMI) today unveiled a strategic partnership between the two organizations, which will provide professionals in the pharmacy benefit management industry with free access to both AJPB and its flagship publication, The American Journal of Managed Care (AJMC).

With the US Food and Drug Administration busier than ever with breakthrough and priority review designations, and the rise of genetic-based treatments offering new hope for patients and families, the pressure is on oncologists to push the limits in care. But if it costs $200,000 to extend life just a few weeks, does that make sense? Are doctors having that conversation? When they do, are patients hearing it? These are the very issues that will be on the table in Baltimore Nov. 14-15 when The American Journal of Managed Care convenes experts from the front line.

The debt ceiling has been raised, and that means that the government will be looking for ways to control long-term budget expenditures, including those for programs like Medicare.