Policy

Exclusions from Medicaid eligibility based on immigration status may be linked with increased health care disparities among immigrant women compared with US-born women, a study suggested.

The limited data on heart failure (HF)-related mortality among young adults, those aged 15 to 44 years, prompted this analysis of data from 1999 to 2019 that considered HF as a contributing or underlying cause of death.

Black and Latino Americans saw surges in health care insurance enrollment through the Affordable Care Act (ACA) between 2020 and 2022; Medicaid enrollment and spending is expected to slow in 2023; the Biden administration is preparing a national hepatitis C treatment plan.

Several elements of the Inflation Reduction Act (IRA) align with CMS’ goals of promoting equity through health policy, explained A. Mark Fendrick, MD, co–editor in chief of The American Journal of Managed Care® and director of the V-BID Center at the University of Michigan.

Melissa O'Connor, PhD, MBA, RN, FGSA, FAAN, endowed professor in Community and Home Health Nursing, M. Louise Fitzpatrick School of Nursing, Villanova University, and director, Gerontology Interest Group, discussed several policy needs for home health care, including improved caregiver support, updated eligibility criteria for in-home care, and reimbursement for telehealth.

The author, the dean of the College of Ethnic Studies at California State University Los Angeles, says a Supreme Court ruling could upend insurance protections for patients with kidney diseases, disproportionately hurting those who are Black, Hispanic, Asian, and other diverse ethnicities.

Despite known racial disparities in access to advanced heart failure (HF) treatments, the reasons for this continue to require further exploration. In this new study, investigators searched for associations between ventricular assist device use and heart transplant and race (Black or White).

CDC advisory group votes to add COVID-19 vaccines to the pediatric immunization schedule; a new report says workplaces can be hazardous to the mental and physical health of Americans; drug makers are lobbying to ease the impact of the Inflation Reduction Act.

The Inflation Reduction Act (IRA) temporarily extended Affordable Care Act premium subsidies and instituted an insulin co-pay cap for Medicare beneficiaries, but bipartisan agreement is needed to make these changes permanent and more broadly applicable, explained A. Mark Fendrick, MD.

It's hard to predict whether the Medicare drug price negotiation provision in the Inflation Reduction Act (IRA) could lead to higher or lower prices in the commercial market, said A. Mark Fendrick, MD, co–editor in chief of The American Journal of Managed Care® and director of the V-BID Center at the University of Michigan.

Compared with Ethiopia’s current nonmandatory hepatitis B vaccination program, expanded vaccination coverage among health care workers was shown to be more cost-effective and result in improved life expectancy gains.

President Joe Biden is directing HHS, through an executive order, to use the Innovation Center to lower drug prices; the US extended the COVID-19 public health emergency for another 90 days; the CDC reported that 75% of teenagers experienced adverse childhood experiences in 2021, which worsened their mental health.

The Inflation Reduction Act (IRA) contains provisions allowing Medicare to negotiate net prices for prescription drugs, but it remains to be seen whether this will translate into savings for beneficiaries, explained A. Mark Fendrick, MD, co–editor in chief of The American Journal of Managed Care® and director of the V-BID Center at the University of Michigan.

The FDA authorizes the COVID booster shots for children as young as 5; babies born during the pandemic may experience delayed communication skills compared with babies born prior; regulatory burden has increased for 89% of medical practices.

On this episode of Managed Care Cast, we speak with Matthew D. Eisenberg, PhD, lead author of a study published in the October issue of The American Journal of Managed Care® that investigated the use of high-deductible health plans and their impact on substance use disorder care and spending.

Stakeholders at the Academy of Managed Care Pharmacy (AMCP) Nexus 2022 meeting review federal legislative and regulatory updates in managed care pharmacy and the impact that upcoming midterm elections will have on these provisions.

The bill was introduced by 2 Republicans and 2 Democrats and would direct HHS to undertake a study to understand how substitution of interchangeable biologic products may be impeded.

The impact of the COVID-19 pandemic on pediatric heart transplant waiting list times was evaluated in this new study that used data from the United Network for Organ Sharing.

The annual fall meeting of AMCP Nexus 2022 will feature a keynote from one of the top physician-executives in health care, the specialty pharmaceutical pipeline, and insights for managed care stakeholders in selecting and integrating cost-effective, value-based care frameworks.

Enrollees who join Medicare Advantage undergo significant turnover in the years following enrollment.

There is wide variation in the governance over research participant pay, and with rapid advances in technology enabling trial access, industry should step up and pay patients what they are worth, says Gunnar Esiason, a patient advocate living with cystic fibrosis.

The recommendations aim to make this type of evaluation more consistent in cases when children have suspicious bruising or bleeding patterns.

The annual report notes that progress in reducing cancer mortality is uneven among populations, with minority groups not seeing the same benefits from therapeutic advances. Cancers related to obesity are also on the rise.

A deal was reached to renew 5-year FDA user fee programs; children and adolescents with COVID-19 had a 60% increased risk of developing type 1 diabetes (T1D); states cannot penalize Department of Veterans Affairs (VA) employees for facilitating abortions permitted by federal law.

Researchers used 2011-2020 data to examine age- and race-/ethnicity-related trends in hypertension diagnosis, with implications for future cardiovascular disease care.

Danielle Carnival, PhD, addressed the National Comprehensive Cancer Network Policy Summit on Friday.

On this episode of Managed Care Cast, we speak with 2 authors of an article in the September issue of The American Journal of Managed Care®, which focused on the results of their evaluation of an intensive, community-based care management program for dual-eligible Medicaid ACO high-risk patients.

Streamlining the prior authorization process can improve care accuracy and patient access to care, writes Siva Namasivayam, CEO of Cohere Health.

A recent study showed that receiving Supplemental Nutrition Assistance Program benefits was not enough to address food insecurity among families whose children were fighting acute lymphoblastic leukemia.

Newer therapies, such as ketamine or esketamine, or the broader use of bright light therapy, made an updated clinical practice guideline for treating major depressive disorder (MDD), but psilocybin and cannabis did not.