Policy

Medicare beneficiaries attributed to small practices in accountable care organizations (ACOs) achieve greater savings than beneficiaries attributed to large practices in ACOs.

A new opinion indicates paying those with substance use disorder to stay clean could be legal; the 2020 Census undercounted some racial minorities; the true global COVID-19 death toll could be 3 times higher than the official tally.

The growth of 340B contract pharmacies since 2010 is unprecedented. This study’s findings suggest that patterns of growth differ between safety-net clinics and hospitals.

Developing alternative payment models for commercial populations in specialties such as oncology is rife with practical challenges. Leading payers and practices share lessons to date.

An analysis of 2019 claims data for California Medicaid enrollees shows large disparities in HIV pre-exposure prophylaxis (PrEP) uptake, especially among Black individuals.

Natalie Dickson, MD, president and chief strategy officer of Tennessee Oncology, discusses Tennessee Oncology's role in the discussion to reform 340B.

A lack of transparency and misaligned incentives had curtailed the adoption of biosimilars in the United States.

This article explores the impact of payment models (fee for service vs salary based) on practice patterns, including wait times and care for patients with chronic diseases.

A new settlement is reached in the Purdue Pharma opioid lawsuit; the US Surgeon General sets out to tackle online health misinformation; Florida poised to enact the state's strictest abortion ban yet.

This article describes the challenges associated with aggregating and reporting quality data via electronic health records and discusses corresponding policy solutions.

A bill to provide late-fee warnings to Medicare beneficiaries was introduced; Pfizer is expected to provide 10 million COVID-19 antiviral pills to low- and middle-income nations; a Texas judge halts an investigation into a 16-year-old girl receiving gender-affirming treatment.

The economic burden of rare diseases based on direct, indirect, and mortality-related costs is 10 times greater than the burden for mass market diseases, such as diabetes and cardiovascular disease, and this burden increases when no treatment is available.

On this episode of Managed Care Cast, Nadereh Pourat, PhD, MSPH, and Alex Sripipatana, PhD, MPH, discuss research on care complexity and utilization patters of patients at federally qualified health centers (FQHCs).

A new lawsuit aims to block a $13 billion health insurance acquisition; the CDC is expected to release updated mask guidelines; the European Medicines Agency supports boosters among teenagers for COVID-19.

In this National Press Club address, American Medical Association President Gerald E Harmon, MD, outlines what steps need to be taken to better prepare the nation for the next pandemic.

On this episode of Managed Care Cast, we discuss how already wide health care inequities in cancer are becoming much worse because of the COVID-19 pandemic, with guest Monica Soni, MD, associate chief medical officer at New Century Health.

Speaking during a webinar presented by the National Alliance of Healthcare Purchaser Coalitions, experts weighed the pros and cons of employer high-deductible health plans (HDHPs) and outlined steps to address challenges raised.

A proposed probe of pharmacy benefit managers (PBMs) by the Federal Trade Commission did not win enough votes to go forward; California exits the crisis phase of the pandemic; Abbott infant formula has been recalled after 1 death.

Pfizer and BioNTech’s Omicron vaccine development has been delayed; a US judge said HHS violated procedural rules in a dispute with AstraZeneca over the 340B drug discount program; Texas filed suit against the CDC’s mask mandate for airline passengers.

The president’s aim is a 50% reduction in age-adjusted cancer deaths by 2047. This goal seems audacious, but it is likely achievable.

The Senate voted 50-46 to confirm Robert Califf, MD, as commissioner of the FDA, which has been without a permanent leader for more than a year.

President Joe Biden's FDA nominee reaches final confirmation vote; Georgia bill that extends Medicaid coverage for low-income moms advances to House of Representatives; New Mexico bill aims to legalize test strips to detect the presence of fentanyl.

By making diligent compliance efforts a priority in the years ahead, health plans can shore up existing processes to achieve financial success and ensure risk adjustment as regulatory bodies take aim at organizational missteps.

The National Clinical Care Commission (NCCC) issued 39 recommendations to improve diabetes prevention and care in the United States.

A new study from North Carolina has investigated individuals’ experiences with and perspectives on their receipt of HIV-related care while incarcerated in 1 of 21 jails in the state.