Health Care Delivery

In a pattern repeated among those who gained insurance on the Marketplace exchanges, it's clear the uninsured had more pent-up medical needs than policymakers realized.

The Affordable Care Act mandated an end to cost sharing for mammograms and colonoscopies if these screenings were preventive. So far, according to a study just published in The American Journal of Managed Care, the change has had little impact, but the verdict may still be out.

Nearly 50 years after President Johnson signed the law that created them, Medicare and Medicaid have become part of the fabric of the US healthcare system. A Kaiser Family Foundation poll finds little support for proposals to alter the basic structure of the programs.

A report released by the healthcare research group Avalere Health claims that health insurance exchanges have a significantly narrow network compared with their commercial counterparts.

The Government Accountability Office received notices of inconsistent information, but it wasn't enough for CMS to cancel coverage for the phony beneficiaries. A key flaw revealed is the ability of phony applicants to use the telephone to bypass online controls.

The ACA eliminated patient cost sharing for evidence-based preventive care, yet this policy has not resulted in substantial increases in colonoscopy and mammography utilization.

Although Hispanic adults were more likely to have a consistent place of care in 2014 compared with 2013, they were still more likely to experience difficulty in accessing and utilizing care than the non-Hispanic population.

Acting Administrator Andy Slavitt says the Fraud Prevention System has yielded a 10-to-1 return for taxpayers

An interview with The American Journal of Managed Care about the PAN Challenge grant.

While new care delivery models have provided better support for patients, there are still many patients who still face challenges with the complexity of treatment, explained Daniel J. Klein, president and chief executive officer of the Patient Access Network (PAN) Foundation.

The newly insured came to Medicaid with medical issues that had gone unaddressed for years. The same problem has been cited by insurers who have asked for large rate increases for 2016 for plans on the exchanges.

The 17th annual HealthCare's Most Wire Survey indicates that hospitals are beginning to utilize information technology to send and share information across care settings.

CDC report estimates that the Affordable Care Act could lead to 111,000 fewer new coronary heart disease events and 95,000 fewer CVD-related deaths by 2050.

President Barack Obama has nominated Andy Slavitt to become the new administrator of CMS.

Cigna and Providence-Swedish Health Alliance ACO in Western Washington recently launched a care collaboration initiative that will benefit more than 7100 individuals who are covered by a Cigna health plan.

New exchange plan enrollees during the first quarter of 2015 spent less on medications than new enrollees during the same time frame 1 year ago

Newly insured consumers under the Affordable Care Act have turned out to be sicker than initially estimated, according to health insurance companies, who are seeking rate increases of at least 20% to 40%, reported the New York Times.

Although nearly equal amounts of people view the Affordable Care Act favorably (43%) as unfavorably (40%), a majority of Americans say they approved of the Supreme Court's decision to continue to allow Americans living in states on the federally facilitated exchange to be eligible for insurance subsidies, according to a recent poll by the Kaiser Family Foundation.

This week GOP presidential candidate hopefuls turned their attention to the 2016 election as the next best chance to repeal Obamacare, and CMS released data revealing $6.5 billion payments to healthcare providers from drug and medical device makers in 2014.

The deal combines Humana's 3.2 million Medicare enrollees with Aetna's 1.26 million Medicare enrollees, giving the new combined company a strong position as the baby boomer population ages.

In addition to increasing insurance coverage, the Affordable Care Act also aims to improve population health and lower healthcare costs. However, not much attention has been paid to the quality of care the newly insured are receiving.

The health coverage of millions of Americans in 34 states was pending upon the Supreme Court decision on the King v Burwell case. Luckily, common sense prevailed and the Supreme Court based its ruling on the original motivation behind the creation of the exchanges rather than on the plain language used in the provision.

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.