What We’re Reading: Billions Invested in COVID-19 Medicines; Hospitals and COVID-19 Mortality; Medicaid Enrollment Increases

June 18th 2021, 2:11pm


The Biden administration has promised to invest billions in antiviral medicine development; certain hospitals associated with Black patients' COVID-19 mortality rates; increased rates of medicaid enrollment.

MedPAC to Congress: Change MA Benchmarks, Slow Down on APMs

June 18th 2021, 12:15pm


The Medicare Payment Advisory Commission (MedPAC) suggested several changes to Medicare Advantage (MA) plan benchmark calculations, with the intent to generate yield savings for Medicare, and urged CMS to streamline alternative payment model (APMs) where it can.

Supreme Court Tosses Challenge to ACA for Lack of Standing

June 17th 2021, 4:23pm


In a 7 to 2 decision, the Supreme Court ruled Thursday that the Affordable Care Act (ACA) will stand, as plaintiffs seeking to declare the law unconstitutional did not have standing.

Commercial and Medicare Advantage Payment for Anesthesiology Services

June 16th 2021, 1:00pm


Mean in-network commercial allowed amounts and charges per anesthesia conversion factor are 314% and 659% of traditional Medicare rates, respectively. Medicare Advantage payments align with traditional Medicare prices.

Pandemic Factors Driving Predictions for 2022 Medical Cost Trends

June 15th 2021, 10:00pm


On this episode of Managed Care Cast, we speak with the author of the annual PwC Behind the Numbers report, which looks ahead at medical cost trends in the United States.

Congress Ends Surprise Billing: Implications for Payers, Providers, and Patients

June 14th 2021, 4:00pm


The No Surprises Act represents a rare bipartisan moment for Congress and a long-needed safeguard for patients that will reorient relationships among payers and providers.

Association Between Hospital-Insurer Contract Structure and Hospital Performance

June 14th 2021, 1:00pm


Hospital performance measures, such as prices and costs, are associated with hospital-insurer contract types.

Adoption of the Lower Drug Costs Now Act May Lead to Billions in Savings

June 11th 2021, 5:00pm


A new study from Milliman investigated the potential financial impact if H.R.3, the Elijah E. Cummings Lower Drug Costs Now Act, was fully implemented.

What We’re Reading: Donating 500 Million Pfizer Doses; Resignation Over Alzheimer Drug; Nevada’s Public Option

June 10th 2021, 2:05pm


United States to buy and donate 500 million COVID-19 vaccine doses to the world; an FDA advisor resigns over a controversial Alzheimer drug approval; Nevada becomes the second state to offer state-managed health insurance plans.

Community-Based Initiative Doubles Accrual Rate of Black Participants in Cancer Trials

June 9th 2021, 3:47pm


An initiative launched with the intent to deliver equitable cancer care improved the enrollment rates of Black participants in cancer clinical trials by focusing on community outreach and engagement.