Policy

A recent study calculated the incidence and mortality rates for patients with Medicaid coverage who had nonventilator hospital-acquired pneumonia (NVHAP) and found possible associations between greater health care costs and NVHAP diagnosis.

Safety-net providers can benefit from demonstrations of condition-specific and defined-scope-of-practice alternative payment models that account for the nonfinancial as well as financial risks that providers face.

Despite the known potential benefits of newborn screening, the exact long-term clinical benefits and cost-effectiveness in large cohorts remain uncertain due to a lack of large-scale longitudinal research.

Social determinants of health are major drivers of the inequities seen in health outcomes, and racism is clearly a social determinant tied to life expectancy, said Karol Watson, MD, PhD, in talk Sunday at the 2022 Congress of the American Society for Preventive Cardiology, held in Louisville, Kentucky.

More people are eligible for screening, but a new analysis suggests lung cancer disparities are due to more than eligibility status.

Duke University’s Pamela S. Douglas, MD, spoke to cardiology professionals who gathered for the start of the 2022 Congress of the American Society for Preventive Cardiology (ASPC), in Louisville, Kentucky.

The study also found broad tolerability, with 98% of patients remaining on the therapy after 12 months.

Children with type 1 diabetes had the highest rates of using continuous glucose monitoring and continuous subcutaneous insulin infusion in Italy, according to recent research, but economic barriers prevent widespread adoption.

This study developed a novel algorithm for setting automatic auditing thresholds in a Medicaid program in Maryland.

Although prediabetes prevalence jumped 4.8 percentage points from 2010 to 2020, barriers to accessing diabetes prevention interventions persist, driven by cost, eligibility requirements, and data integration, leading to low participation rates.

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.