Insurance

Medicare Diabetes Prevention Program: Where Are the Suppliers?

June 12, 2020

Despite the Medicare Diabetes Prevention Program now being a covered benefit, there is inadequate availability of suppliers to reach Medicare beneficiaries with prediabetes.

Racial Disparities Shift in Observation Status in Hospital Admissions for Avoidable Conditions

June 02, 2020

A study released Monday used national Medicare data to try and understand disparities between black and white patients in avoidable hospitalizations for ambulatory care–sensitive conditions.

How Comorbidities Affect Costs and Costs Impact Nonadherence in RA

May 29, 2020

For patients with rheumatoid arthritis (RA), cost can play a role in patient adherence to medication, but the presence of comorbidities does not impact cost of care for patients, according to 2 abstracts presented at the Virtual 2020 International Society for Pharmacoeconomics and Outcomes Research meeting.

This Week in Managed Care: May 29, 2020

May 29, 2020

This week, the top managed care news included lower insulin costs for seniors in certain plans; discussions on the future of the Biologics Price Competition and Innovation Act; takeaways from Sharecare's Flatten the Curve Survey.

Seniors in Certain Part D Plans, Medicare Advantage to See Insulin Costs Capped in 2021

May 26, 2020

President Trump announced the plan today at the White House, accompanied by insulin manufacturers Eli Lilly, Novo Nordisk, and Sanofi, as well as AHIP and major health plans.

Examining the Links Among Diabetes Education, Activity, and Food Insecurity

May 24, 2020

The presentation at Virtual ISPOR 2020 found that 7% of a group of Medicare beneficiaries with type 2 diabetes was experiencing food insecurity, a rate the lead author found "alarming."

Early Detection Programs May Help Offset Costs of COPD Exacerbations, Studies Find

May 21, 2020

Exacerbations of patients with chronic obstructive pulmonary disorder (COPD) can be costly if they are frequent, and early detection programs for COPD may help offset these costs, according to research from 2 studies presented at the 2020 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) virtual conference.

Pulmonary Rehabilitation for COPD Linked to Lower Risk of Death in FFS Medicare

May 12, 2020

Although pulmonary rehabilitation for chronic obstructive pulmonary disease (COPD) is linked to better survival, a large study of fee-for-service (FFS) Medicare patients show it is underused, with less than 2% of those studied taking part in a 3-month program.

Lindsay Greenleaf Discusses the 2021 Medicare Advantage Rate and Related Effects of COVID-19

April 19, 2020

The American Journal of Managed Care® spoke with Lindsay Bealor Greenleaf, JD, MBA, Vice President of Policy, ADVI Health, about CMS’ recent enactment of the 2021 Medicare Advantage rate announcement, and the effects of COVID-19 on Medicare Advantage. This transcript has been edited slightly for clarity.

Anticipating COVID-19 Losses, ACOs May Drop Out of MSSP

April 13, 2020

More than half of risk-based accountable care organizations (ACOs) currently enrolled in the Medicare Shared Savings Program said they are likely to drop out due to the fear of paying losses resulting from the coronavirus disease 2019 (COVID-19) pandemic, according to a survey conducted by The National Association of Accountable Care Organizations.