Insurance

Using longitudinal Medicare claims data, this study quantified the association of the Medicare Part D coverage gap with medication adherence among beneficiaries with chronic obstructive pulmonary disease.

The successor to an earlier value-based effort in primary care could reach 5000 practices and 3.5 million patients. The original model showed transformation but had not yet shown savings after 2 years.

Two consultants who help stakeholders in value-based transitions say CMS is serious about an aggressive pace for payment reform.

World Lung Cancer Day is a grassroots effort conceived by a lung cancer survivor. Here are a few updates on ways to prevent the disease and manage treatment.

The most recent pattern of healthcare spending among Americans appears to show a divergence of expenditures trends for the wealthy, middle class, and poor, which suggests a redistribution of care toward wealthier Americans.

This week, the top stories in managed care included the release of Medicare's Star ratings for hospital quality, a new proposal from CMS to require bundled payments for cardiac care, and an FDA panel recommended approving a continuous glucose monitoring system for dosing insulin.

What we're reading, July 28, 2016: CMS released first hospital quality ratings; Anthem is prepared to fight the government over Cigna purchase; and regulations are falling behind stem cell clinics.

The report found that in-person coaching and digital formats with human coaching were both effective and delivered value. ICER's review comes as Medicare is creating reimbursement standards to take effect in January 2018.

What we're reading, July 27, 2016: UnitedHealth and Aetna are looking to join California's Medicaid program; the World Health Organization is considering removing transgender identity from list of mental disorders; and medical schools rethink how to treat addiction.

A new review of Medicare prescription drug plans suggests that these plans need incentives that will push them to consider long-term outcomes and costs because they tend to consider only short-term clinical outcomes and costs related only to the pharmacy benefit.

Presented by The Atlantic at the Democratic National Convention, the forum saw members of Congress, a scientist, and a patient all call for more prevention and early intervention in a disease that could swamp the federal budget by 2050.

Critics of the Hospital Compare "Star" ratings ask whether the failure to take patient wealth into account unfairly penalizes hospitals that care for larger numbers of poor patients.

This would be the second group of procedures targeted for bundled payments in Medicare. Rules for hip and knee replacements went into effect in April in 67 markets.

What We’re Reading, July 25, 2016: Keeping dementia at bay in the elderly; PhRMA spends more and insurers spend less on lobbying, so far in 2016; and a record-breaking fraud case in Florida.

In a conference call the morning after a landmark vote, Dexcom's president and CEO said the company will not wait for final FDA approval to start talks with CMS.

CMS' Innovation Center created Million Hearts to identify Medicare beneficiaries most at risk of heart disease and cardiovascular events.

There are signs that smaller providers, in particular, are not moving toward value-based reimbursement at the same pace as larger healthcare stakeholders.

The update of the Urban Institute’s 2015 analysis suggests that the nation continues to be on track to spend much less on healthcare over the next several years than was projected by CMS in late 2010.

A study presented at the annual meeting of the American Society of Clinical Oncology by a group from Israel that evaluated the price trend of 30 anticancer agents following their launch, found that prices may increase by as much as 44% even after adjusting for inflation.

The transactions were announced a year ago right after a Supreme Court decision that left subsidies for the federal health exchange intact.