Policy

Rates for reimbursement cuts will be lower than expected within Medicare Advantage plans; financial safety nets, in the form of Social Security and Medicare, are likely to be unable pay full benefits; CDC teams experience symptoms similar to East Palestine, Ohio, residents following train derailment

The ruling of Braidwood Management v Becerra puts HIV pre-exposure prophylaxis (PrEP) coverage at risk, potentially leading to more than 2000 preventable HIV infections in the coming year.

Digital health data can facilitate the participation of underrepresented and diverse patient populations in clinical trials, but first the FDA must build its capability to evaluate such information in its regulatory processes for new drug development.

Pharmacy benefit manager reform is a major trend in state managed care policy, said Adam Colborn, director of government relations at the Academy of Managed Care Pharmacy (AMCP).

A panel assembled at the American Academy of Dermatology 2023 Annual Meeting encouraged the audience of dermatologists to advocate together for needed changes in payment, access, and practice.

Gov. Mark Gordon sings a ban on the use of abortion pills in Wyoming; a new study shows that Affordable Care Act has reduced racial disparities in health care; California Gov. Gavin Newsom announces a contract to make affordable insulin.

Preventing tobacco use has saved Californians billions, according to recent research.

Speakers at the American Academy of Dermatology 2023 Annual Meeting highlighted the potential of DataDerm to tell the story of dermatological care in the United States, but some also cautioned that the registry only reflects those who have access to care in the first place.

The authors highlight the diversity of multiagency electronic data-sharing approaches and present a case study addressing the opioid crisis

Since 2004, the number of individuals with HIV receiving antiretroviral therapy (ART) has increased 300-fold through the US President’s Emergency Plan for AIDS Relief (PEPFAR).

The Biden administration released the list of 27 Medicare Part B drugs that are subject to rebates back to the government for having price increases that rose faster than inflation as well as the removal of out-of-pocket costs for some vaccines covered under Part D.

Community social determinants of health such as rurality and low socioeconomic status moderate the association between an individual’s race and emergency care use.

Biden’s proposed budget emphasizes expanding health care and lowering drug costs; nasal spray zavegepant (Zavzpret) approved for treating adults with acute migraine; updated guidelines may help more women detect breast cancer early on.

Health plans use data to decide on quality improvement initiatives. Having a dashboard that characterizes how equitably plans are serving their enrollees would promote health equity.

Cyber attacks on health care are raising cyber insurance costs; Democrats and Republicans clash over what constitutes a cut vs a reform; rural hospitals begin conversion under a new federal payment program.

Medicaid expansion deal proposed in North Carolina; FDA gains new leverage over quick drug approvals; Walgreens announces it will not dispense abortion pills in several states where it’s legal.

The FDA approved the first drug for the rare disease Friedreich’s ataxia; House Republicans seek information from pharmacy benefit managers (PBMs); FDA panel narrowly supports respiratory syncytial virus (RSV) vaccine for older adults.

A new investigation blames the COVID-19 pandemic on a leak from a laboratory in China; Colorado proposes co-pay limits for EpiPens; the first at-home flu and COVID-19 test maker, Lucira Health, declares bankruptcy.

Court decision could ban abortion pill, mifepristone, nationwide; Illinois gears up to fight mental health crisis among children; CMS rejects expanded coverage for Alzheimer drug, Leqembi.

Senators concerned over health care worker shortages; Medicaid beneficiaries left unaware of renewal deadline; Ohio to open health clinic after toxic train derailment.

The Biden administration sends medical experts to the site of the derailed train carrying hazardous materials in Ohio; senators push for pharmacy benefit manager (PBM) reforms; Kentucky Supreme Court proceeds with near-total abortion ban.

High patient experience scores were associated with the collection and use of any clinician performance information, especially with whether the practice shared this information internally to compare.

Social Security and Medicare spending could double by 2023; FDA panel experts want naloxone to be available over the counter after the drug information is revised; Moderna announced its COVID-19 vaccines will stay free, and the Biden administration might keep tests and treatments free for the uninsured.

Using data from 632 primary care practices, the authors show that the CMS Practice Assessment Tool has adequate predictive validity for participation in alternative payment models.

On this episode of Managed Care Cast, we speak with Inland Empire Health Plan, a managed care plan serving more than 1.4 million residents on Medi-Cal in California, about a new maternal mental health program aimed at supporting new mothers, both before they give birth and afterward.

HHS wants to require nursing homes to disclose more ownership and management information; privacy advocates warn that mental health data can legally be sold from certain platforms not covered by the Health Insurance Portability and Accountability Act; the FDA won’t review Soligenix’s cancer drug proposal because of an insufficient application.

Congress has no solution for out-of-network ambulance rides; teenagers going to an emergency department in a mental health crisis don't receive necessary follow-up care; Medicaid explores nutritional benefits of food as medicine spending in some states.

Overall survival and recurrence-free survival showed substantial improvement when physicians more closely followed quality recommendations for non–small cell lung cancer (NSCLC).