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CMS has announced that it will nearly double the number of candidates in its bundled payment program. As part of the Affordable Care Act, the program aims to reduce care costs and improve patients' quality of care by offering providers with an alternative to the traditional fee-for-service reimbursement model.

A study just published in The American Journal of Managed Care examined how benefit design differences affected seniors who received prescription coverage through Medicare Advantage compared with a stand-alone Medicare drug plan. The review showed that integrating drug coverage with medical care resulted in fewer barriers to name-brand drugs, with lower copayments.

Uncompensated care was supposed to be a thing of the past, but it's persisting in many states not expanding Medicaid eligibility. As an alternative, for some high-cost uninsured patients, hospitals are turning to a new option.

Changes to a hospice drug rule will reduce the types of medications that require prior authorization. Previous rules prohibited Medicare hospice patients from filling their Part D medications until they had confirmed that hospice providers did not cover them first.

Fewer patients linger for days in hospitals without being admitted because of a new federal rule, but hospital and consumer groups are suing the government because they say the policy compromises Medicare patients' care, and patients are often stuck with costly, unexpected bills.

Wellness and behavioral health visits are among a few telehealth coverage expansions the CMS wants to add to the list of Medicare-reimbursable telehealth activities under a proposal released Thursday.

The American Journal of Managed Care followed up the first meeting of its ACO and Emerging Healthcare Delivery Coalition with its first interactive conference call, which was open to all members. Anthony Slonim, MD, DrPH, a Coalition co-chair who on July 1 will become president and CEO at Renown Health in Reno, Nev., moderated the roundtable discussion.

The drug industry scored a victory last month against the Obama administration's plans to give hospitals millions of dollars in discounts through the 340B program on orphan drugs. But HHS is sticking to its position that the Patient Protection and Affordable Care Act promises breaks on the expensive drugs when they're used for non-orphan indications.

Dr Chernew asks panelists about the role of insurers and Medicare for patients in the treatment of multiple myeloma. While insurers may not have necessarily been a barrier to care, costs of drugs have been.

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