Insurance

How Can the COVID-19 Pandemic Enhance Value-Based Health Care Delivery?

August 12, 2020

Given the constraints prevalent post-COVID-19, Dr Mark Fendrick, director of the University of Michigan Center for Value-Based Insurance Design, stresses that it is now more important than ever for the health care industry to prioritize payment reform, value-based benefit design, and novel policy initiatives.

Can a Community-Based Care Management Program Reduce Costs, Visits Among Medicaid Enrollees?

August 06, 2020

Krisda H. Chaiyachati, MD, MPH, MSHP, discusses the study he co-wrote entitled “Economic Outcomes of Insurer-Led Care Management for High-Cost Medicaid Patients.”

Trump Signs 4 Executive Orders in Effort to Carry Out Promise to Lower Drug Prices

July 25, 2020

The orders President Trump signed Friday include a deadline for the pharmaceutical industry to come up with their own plan by August 24 to lower prices.

What We're Reading: Vaccine Distribution Agreement Announced; Virus Deaths Surge Again; Medicare Insolvency Predicted

July 22, 2020

The US government partners with biotech giants Pfizer and BioNTech to distribute a coronavirus disease 2019 (COVID-19) vaccine; the COVID-19 death record continues to be broken; could Medicare be in financial trouble?

CMS Seeks Incentives for At-Home Dialysis in Wake of COVID-19

July 07, 2020

End-stage renal disease has long been one of the most expensive and debilitating conditions that affects Medicare beneficiaries. Not only does dialysis cost $90,000 a year—those awaiting a kidney transplant automatically qualify for Medicare—but the need to travel to a dialysis center multiple times a week disrupts employment and home life.

Gauging the Experiences of the Seriously Ill in California: Analyzing Serious Illness Beyond Medicare Fee-for-Service

July 02, 2020

Significant populations of seriously ill individuals are insured by all lines of business and have meaningfully different needs and medical histories in California.

Study Highlights Variation in Second-Generation Diabetes Drug Use Among Medicare Enrollees

June 22, 2020

Among Medicare enrollees, there was substantial between-practice variation in the use of second-generation diabetes drugs between 2007 and 2015, according to a study published in JAMA Network Open. Data also revealed a concentration of use among a few prescribers and practices, who were responsible for widespread early diffusion.

Strategies for Implementing Best Practices in Independent Physician Associations

June 16, 2020

The objective of this research was to identify strategies that significantly lower unnecessary inpatient utilization among Medicare beneficiaries with chronic disease.

Dr Robert Gabbay Reflects on Insulin Cost Caps for Some Medicare Beneficiaries

June 14, 2020

The announcement of a $35 per month out-of-pocket cap for insulin for some individuals with Medicare is a real victory for the American Diabetes Association and for people with diabetes, said Robert Gabbay, MD, PhD, chief medical and scientific officer of the American Diabetes Association.

AJMC® in the Press, June 12, 2020

June 12, 2020

Coverage of our peer-reviewed research and news reporting in the health care and mainstream press.