Policy

This study compares the impact of the 3 different out-of-pocket maximums proposed in Congress and by the Medicare Payment Advisory Commission.

A meta-analysis from 3 economists concluded that nonpharmaceutical interventions in response to COVID-19 failed to have a large, significant effect on mortality rates.

New CDC data highlight urban-rural health differences; mental health providers object to some parts of the No Surprises Act; COVID-19–associated stroke most likely within 3 days of diagnosis.

Among a patient population defined by CMS postacute care transfer regulations, home health vs no postacute care was associated with reduced 30-day readmissions and costs.

On this episode of Managed Care Cast, we speak with Meghan Gutierrez, CEO of the Lymphoma Research Foundation, about financial toxicity, how the pandemic has affected patients’ financial needs when they have cancer, health care disparities and care gaps, and more.

Medicaid managed care utilization review data for mental health services were analyzed for the calendar years 2017 and 2018. These data indicate low rates of utilization review denials for both inpatient and outpatient mental health services.

Americans who are boosted are 95 times less likely than unvaccinated people to die of COVID-19, the FDA approved the first generic drug for Restasis to treat dry eye syndrome, and CMS is putting a greater focus on health equity for Medicare Advantage and Part D plans.

The rise in popularity of genetic testing brings along a myriad of challenges ranging from concerns on data privacy to insurance coverage, but, when utilized correctly, it could mark a step forward for significant advancements in individual and population health.

Up to one-fifth of Medicare beneficiaries were unable to access health care due to the COVID-19 pandemic in 2020.

The Oncology Care Model (OCM) is set to expire June 30, 2022. With no successor on the horizon, respondents to a recent survey by the Community Oncology Alliance (COA) say features such as dedicated navigators and weekend appointments could be reduced or lost if revenues that supported them are eliminated.

Little-known drugs are now contributing to the US overdose epidemic; the Government Accountability Office finds HHS is at "High Risk Alert"; Moderna begins HIV vaccine trial.

In its annual Medicare Shared Savings Program (MSSP) report, CMS said the number of accountable care organizations joining increased, but a trade group said the results should have been better.

A study found 4 factors may correlate with increased risk of long-term COVID-19; Rhode Island joins opioid settlement against McKesson, AmerisourceBergen, and Cardinal Health; the Environmental Protection Agency announced it will station mobile equipment in Louisiana to measure air pollution.

The Biden administration will distribute 400 million nonsurgical N95 masks; a study aims to develop a questionnaire to enable gay and bisexual men to donate blood; counterfeit versions of Gilead HIV treatments were discovered in 9 states.

On this episode of Managed Care Cast, Mark Miller, PhD, the executive vice president of health care at Arnold Ventures, outlines what Americans can expect from the newly enacted No Surprises Act.

New data show that Medicaid enrollees with diabetes in Colorado have greater access to new medications and incur less associated costs compared with patients with Marketplace plans.

Cloth masks are not as effective at curbing the spread of COVID-19 as surgical masks; Martin Shkreli is banned from the pharmaceutical industry; as infections increase, more COVID-19 variants are likely.

Senate panel votes to advance Robert Califf, MD, as the new head of the FDA; rising global temperatures spell increased health challenges; Omicron cases may be peaking in some Northeast cities.

The deadline to enroll in health insurance available through the Affordable Care Act on the federal exchange is Saturday, January 15.

In a National Coverage Determination decision memo released Tuesday, CMS said it will gather public comment for 30 days about its plan to limit coverage for Alzheimer disease (AD) biologics that target plaque buildup in the brain to patients enrolled in certain clinical trials.

On this episode of Managed Care Cast, we interview the lead author of a paper in the January issue of Health Affairs about what physicians know and don't know regarding their responsibilities to accommodate patients with disabilities when they come in for an office visit.

CDC officials clarified the agency's new isolation recommendations for individuals infected with COVID-19 and provided updates on its efforts to reduce pediatric cases among those too young to receive vaccines.

CMS proposed rulemaking Thursday that would pass pharmaceutical price concessions to beneficiaries in Medicare Part D plans and make the medical loss ratio in Medicare Advantage plans more robust.

The Biden administration doubled its order of Pfizer’s COVID-19 antiviral drug; California is now the first state to require health insurance plans to cover at-home STI tests; the Supreme Court will hear in-person arguments Friday to decide whether to block federal vaccine mandates.

The update recommends that patients who receive CAR T-cell therapy wait 3 months before getting a COVID-19 vaccine.