Policy

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.

Limited evidence from a literature review suggests that co-pay assistance was associated with improved treatment persistence/adherence across various diseases, with indirect evidence suggesting improvements in clinical outcomes.

At the Pharmacy Quality Alliance (PQA) 2022 Annual Meeting Wednesday, participants heard about some unexpected insights arising from a workshop held this week between patients and pharmacists who are creating a patient-centered outcomes research agenda focused on addressing social determinants of health (SDOH) in the community pharmacy setting.

Using socioeconomic status (SES) as their primary exposure, investigators from McGill University, University of Manitoba, Institut National de Santé Publique du Québec, and Laval University investigated reasons behind insulin pump uptake disparities in the Canadian provinces of Manitoba and Québec.

Value-based payments were a benefit during the pandemic, but it remains to be seen if patients are interested in keeping those changes in care delivery as the pandemic recedes, said Jayson Slotnik, partner, Health Policy Strategies, Inc.

On this episode of Managed Care Cast, Ari D. Panzer, BS, lead author and researcher, then at Tufts Medical Center—now at Duke University—discusses the findings from his team’s investigation into coverage decisions by health plan insurers of the 66 drugs approved by the FDA in 2018.

Scott Gottlieb, MD, and Adam Fein, PhD, discussed potential fallout of the FDA Aduhelm approval and lessons learned from the COVID-19 pandemic.

Of the 5800 patients included in study, 20% were Black, which the researchers say adequately represents disease incidence among the population.

Patricia Deverka, MD, MS, senior researcher, deputy director at the Center for Translational and Policy Research and Precision Medicine, University of California San Francisco, explains what multicancer early detection tests currently exist and the research needed to understand their clinical utility.

A new drug has been approved for obstructive hypertrophic cardiomyopathy (HCM); Oklahoma enacts a strict abortion ban; whistleblower claims alarms had been raised about Abbott baby formula contamination.