Policy

On this episode of Managed Care Cast, Hui Zheng, PhD, discusses his recent research on the association between childhood income inequality and declining adult health.

The organizations that can take on 2-sided risk are usually bigger and that’s not always better for health care, said Jayson Slotnik, partner, Health Policy Strategies, Inc.

The governor of Oklahoma signs the nation's most restrictive abortion ban; vaccination against COVID-19 may not prevent long COVID-19; West Virginia reaches tentative settlement with opioid manufacturers.

Thanks to flexibilities provided by the American Rescue Plan, 4 states announced Wednesday they will expand Medicaid coverage to 12 months postpartum, joining others who have already adopted similar measures.

Miruna Sasu, PhD, MBA, president and CEO of COTA Healthcare, discusses 3 ways in which the FDA can provide, and has provided, assistance on the capture of real-word data (RWD) in electronic medical records.

Thirst outcomes were investigated among patients with stable heart failure (HF), due to the limited data available on this relationship and how it, along with fluid and sodium intake, influences clinical outcomes in this population.

United States birth rate rises from last year but is still lower than pre-pandemic; a drug plant closure in California could affect availability of 5 essential medications; the No Surprises Act prevented 2 million potential surprise bills in first 2 months of 2022, report says.

During a State-of-the-Art Lecture at Digestive Disease Week 2022, Jessica L. Mellinger, MD, MSc, explained how the COVID-19 pandemic has driven increases in rates of alcohol use and associated liver disease, as well as what can be done at the clinic, societal, and policy levels to address these trends.

Pfizer announced positive data of its COVID-19 shot regimen for children under 5 years; providers gear up for increased challenges in distributing abortion medication; hypoallergenic baby formula shipments arrive in the United States.

Roxana Siles, MD, FAAAAI, staff in the Department of Allergy and Immunology at Cleveland Clinic and codirector of the Asthma Center at Cleveland Clinic, discusses the important need for chronic cough therapies and what issues with current treatments should be addressed by next-generation medications.

The tools we need to achieve long-term stability for community providers and ensure better outcomes for rural Americans are available, and CMS can help us utilize them.

Lawmakers in Oklahoma pass the nation's most restrictive abortion ban; racial disparities in cancer death rates persist; earlier onset of puberty sparks concern among physicians, researchers.

On this episode of Managed Care Cast, Tham Thi Le, PhD, MPH, lead author—then at the University of Maryland at Baltimore, now at AstraZeneca—and Linda Wastila, PhD, MSPH, senior author and the Parke-Davis Chair in Geriatric Pharmacotherapy, Pharmaceutical Health Services Research, at the University of Maryland at Baltimore, discuss the findings of their investigation into opioid use by patients with a new cancer diagnosis and the opioid prescribing practices of their health care providers from 2007 to 2013.

New data show extreme heat waves were associated with higher all-cause mortality throughout the United States, with increased risks seen among men, the elderly, and non-Hispanic Black individuals.

On this episode of Managed Care Cast, we speak with one of the authors of a paper published this month in Health Affairs about the utilization of substance use disorder treatment (SUD) services between 2010 and 2019, and why more needs to be done to get more individuals into treatment.

The report details totals paid to hospitals by private insurers and providers and compares the sums with a Medicare benchmark.

The Amputation Reduction and Compassion Act (H.R. 2631) would ensure that Medicare and Medicaid both cover peripheral artery disease screening for at-risk beneficiaries without the cost-sharing requirements that could make some patients balk at seeking care.

President Joe Biden announces plans to improve baby formula shortages; Massachusetts reaches settlement with veterans who contracted COVID-19 in long-term care facility; a quarter of Medicare beneficiaries were harmed from hospital stays in 2018.

While CMS has started making changes to address health equity through policy and payment models, commercial plans are waiting to see the outcomes before they follow suit, said Jayson Slotnik, partner, Health Policy Strategies, Inc.

This study found extensive variation in general internal medicine physician prices and that high-priced physicians provided fewer low-value services but had higher spending on these services.

In an effort to bolster development of treatments for rare diseases, the FDA announced the creation of the new Accelerating Rare disease Cures (ARC) program.

In a session at the 2022 Asembia Specialty Pharmacy Summit, Jayne Hornung, chief clinical officer at Managed Markets Insights & Technology (MMIT), outlined factors driving payer hesitation when it comes to covering prescription digital therapeutics.

Lower-salary employees in high-deductible health plans underutilize outpatient care and overutilize emergency departments.

Holding other factors constant, the authors find that older providers prescribe significantly more opioids, with the gap between older and younger providers increasing from 2010 to 2015.

Future quality conversations must recognize what the pandemic has illustrated over the past 2 years—that patients who were in the most dire need of health care, including those with multiple chronic conditions, had the least amount of access, said Jonathan Blum, MPP, the principal deputy administrator and chief operating officer of CMS.