Policy

The cost avoidance of heart failure–related hospitalizations and emergency department visits may outweigh the additional drug cost in Medicaid members adherent to sacubitril/valsartan.

This study attempts to identify the sources of the significant 2.5-fold variation found in home health expenditures, a possible indicator of inefficiency and waste.

On this episode of Managed Care Cast, we find out about efforts by a managed Medicaid health care plan in Southern California to bring prevention and intervention mental health services to schools in response to a worsening crisis among America's children and adolescents.

Four large Medicare Advantage insurers manage access to expensive physician-administered drugs with a combination of prior authorization, step therapy, and Part D formulary design.

Governor Phil Murphy signed legislation tightening New Jersey gun laws; the FDA temporarily suspended the ban on Juul sales; researchers found a cancer drug reduced risk of death among people hospitalized with COVID-19 by half.

Over the past decade, the Veterans Health Administration (VHA) has sought to boost lung cancer screening rates, but several challenges remain.

Integrating primary care with behavioral health services, improving provider training on mental health, and policy changes were all noted as strategies to combat the rising mental health and substance abuse epidemic during a keynote session at AHIP 2022.

In the second of 2 parts, Nathan H. Walcker, MBA, CEO of Florida Cancer Specialists & Research Institute (FCS), discusses what he’d like value-based care to look like going forward. CMS ended the Oncology Care Model (OCM) yesterday after 6 years and has invited practices to apply for a successor model, the Enhancing Oncology Model.

Panelists of a keynote session at AHIP 2022 discuss how lessons learned from investment and infrastructure in public health during the COVID-19 pandemic can be leveraged to promote equitable care for all Americans and prepare for the next public health emergency.

Will Nutland, DrPH, is cofounder of PrEPster, honorary assistant professor at the London School of Hygiene and Tropical Medicine, and an activist.

In the first of 2 parts, Nathan H. Walcker, MBA, CEO of Florida Cancer Specialists & Research Institute (FCS), discusses the future of value-based care for the practice as the Oncology Care Model comes to an end today. This week, CMS announced it will launch a successor model.

Senators did not approve the 9-nominee commission to reshape the Veteran Affairs health care system; US population is getting older and more diverse; HHS issued guidance to protect patient privacy related to sexual and reproductive care.

Medicare Advantage (MA) plans are denying care while overcharging the government, watchdogs said at a Congressional hearing; overturn of Roe v Wade will not change how military treatment facilities provide abortions; the CDC activates the Emergency Operations Center in response to monkeypox.

On this episode of Managed Care Cast, we speak with Georges C. Benjamin, MD, executive director of the American Public Health Association, on the core takeaways of his keynote session at AHIP 2022 on public health policy and other solutions to promote equitable health and well-being.

In response to the Supreme Court last week overturning the landmark 1973 Roe v Wade decision, after previously upholding the constitutional right to an abortion in Planned Parenthood of Southeastern Pennsylvania v Casey, HHS Secretary Xavier Becerra outlined the next steps for the Biden administration.

A possible connection between integrase strand-transfer inhibitor (INSTI) use for HIV and cardiovascular disease (CVD) was investigated in this new study from an international team wanting more knowledge on the drug class’s treatment effects.

Americans with disease and disabilities are disproportionately affected by public policy, with their health outcomes at the complete mercy of lawmakers.

Panelists of an AHIP 2022 session discussed how future policy, infrastructure, and investment strategies in public health will reinforce the efforts already made during the pandemic, with partnerships and engagement key to optimize innovation.

The Senate passed a bipartisan gun law, the first major gun legislation in nearly 30 years, which now goes to the House; HIV cases dropped during the pandemic, perhaps due to lack of testing; researchers say COVID-19 vaccines have saved nearly 20 million lives but could be even more effective.

Reversing a landmark precedent, the Supreme Court voted Friday to overturn 1973’s Roe v Wade decision that guaranteed American women the constitutional right to an abortion, and at least 1 justice suggested that other precedents, such as the right to birth control, be reversed as well.

Patients who received a diagnosis of small cell lung cancer (SCLC) between 2010 and 2016 had a nearly 2% increase in overall survival vs those who received their diagnosis between 2004 and 2010.

Most patients taking a biologic stayed on the therapy, and most saw decreases in exacerbations, a new study has found.

The findings of this study, which used insurance claims data for patients 2 years and older to determine rates of meningococcal A, C, W, Y vaccine uptake, points to the need for more education, the authors said.

The FDA plans to set a maximum nicotine level in cigarettes and tobacco products to reduce addictiveness; a bipartisan bill would place a $35 monthly cap on insulin for patients with private insurance or Medicare; the Supreme Court ruled that an Ohio hospital’s employee health plan did not violate federal law by limiting coverage for outpatient dialysis.

A new report from the Office of Inspector General (OIG) of HHS suggests the accuracy of Medicare’s race and ethnicity data will only diminish over time, unless changes are implemented.