Insurance

Examining SDOH in a Commercially Insured Health Care Workforce

April 22nd 2021, 7:04pm

At a session at the National Association of Managed Care Physicians Virtual Spring Managed Care Forum, an Aetna executive discussed how one employer used the payer's data to see how its workforce was affected by social determinants of health (SDOH).

Removing Barriers to Mental Health Care for Children and Teenagers

April 20th 2021, 8:38pm

Podcast

On this episode of Managed Care Cast, we speak with the chief strategy officer for Well Being Trust, one of the authors of a recent report about how well health insurers and state Medicaid programs are covering mental health care for children and compliance with federal law. We discuss the unique challenges that youth face, the health disparities, racism, and community trauma that has been experienced in the past year, and some creative ways that organizations and communities can consider increase access to mental health supports.

Avalere Report Looks at Geographic Challenges to Accessing CAR T-Cell Therapies

April 17th 2021, 1:29am

Article

Given that some patients may need to travel out of state to access CAR T sites of care, some may not have a clear understanding of their insurance benefits, including requirements for out-of-state or out-of-network treatment, as well as adequate assistance with the costs of medical-related travel.

Low-Income, Non-White Patients Delay Care Using HDHPs, Study Says

April 15th 2021, 7:02pm

Article

A poster at the Academy of Managed Care Pharmacy 2021 meeting examined the impact of high-deductible health plans (HDHPs) on access to health care and resource use in the United States and the interaction of race, ethnicity, and income.

Senate Bill Seeks to Limit Use of Step Therapy in Employer Health Plans

March 27th 2021, 10:45am

Article

The bipartisan bill spells out 5 step therapy exemptions for patients by amending the Employee Retirement Income Security Act of 1974.

Cigna Dangles $500 to Persuade Patients to Switch Psoriasis Drugs

March 26th 2021, 9:58pm

Article

As the first quarter of 2021 ends, patients choosing to keep using secukinumab may be offered an inducement to switch to another biologic, ixekizumab.

White, Brown Bagging of Therapies Creates Extra Steps for Oncology Practices

March 18th 2021, 10:30pm

Article

Pharmacists from the Cleveland Clinic discuss the impact of payer dispensing requirements, known as white bagging and brown bagging, on oncology practices and on patients.

Shifting Dialysis Away From Employer-Based Coverage Cost Medicare $3 Billion, Study Finds

March 18th 2021, 3:00pm

Article

The study examined the cost to Medicare when patients with end-stage renal disease switched from their employer-based health insurance to Medicare between 2007 and 2017 before the end of the 30-month coordination period.

Early Adopters of VBID Sought to Remove Barriers to High-Value Care

March 17th 2021, 1:30pm

Article

A desire to remove barriers to high-value care and provide services that would improve health and quality of life drove early adopters of value-based insurance design (VBID).

Nonmedical Switching Led to Gaps in COPD Care, Study Says

March 16th 2021, 10:45pm

Article

After Medicare Part D plans stopped covering a chronic obstructive pulmonary disease (COPD) therapy, patients had gaps in care and increased out-of-pocket costs, according to a recent study.