Policy

Mean in-network commercial allowed amounts and charges per anesthesia conversion factor are 314% and 659% of traditional Medicare rates, respectively. Medicare Advantage payments align with traditional Medicare prices.

On this episode of Managed Care Cast, we speak with the author of the annual PwC Behind the Numbers report, which looks ahead at medical cost trends in the United States.

The No Surprises Act represents a rare bipartisan moment for Congress and a long-needed safeguard for patients that will reorient relationships among payers and providers.

Hospital performance measures, such as prices and costs, are associated with hospital-insurer contract types.

A new study from Milliman investigated the potential financial impact if H.R.3, the Elijah E. Cummings Lower Drug Costs Now Act, was fully implemented.

United States to buy and donate 500 million COVID-19 vaccine doses to the world; an FDA advisor resigns over a controversial Alzheimer drug approval; Nevada becomes the second state to offer state-managed health insurance plans.

An initiative launched with the intent to deliver equitable cancer care improved the enrollment rates of Black participants in cancer clinical trials by focusing on community outreach and engagement.

In this episode of Managed Care Cast, we speak with a coauthor of an article in June’s Health Affairs examining the racial and ethnic composition of beneficiaries in Medicare Advantage plans and the potential implications as the program continues to grow.

The researchers created a model that simulated what would happen when health systems and providers began working together in Medicare accountable care organizations (ACOs) in arrangements that did not extend to outright mergers or acquisitions.

The founder of the Renal Support Network discusses why patients with chronic kidney disease want Congress to change Medicare policy to allow payment for oral treatments for anemia caused by iron deficiency.

President Joe Biden announces a new initiative to get more adults vaccinated against COVID-19; Purdue Pharma may be immune from future opioid-related lawsuits; the California senate approves a bill decriminalizing psychedelic drugs.

On this episode of Managed Care Cast, a research scholar at the Marron Institute of Urban Management at New York University discusses the latest findings in the Health of the Air report, which was presented at the recent American Thoracic Society 2021 International Conference.

A new analysis reveals penalties levied under a CMS program to improve the quality of care at dialysis centers did not lead to significant change.

In the control of COVID-19, the future perfect of the vaccine should not be the enemy of the present good, which is masking.

Results from Sharecare's Community Well-Being Index show Massachusetts was the healthiest state in 2020 while Mississippi ranked last.

Expanded coverage under a Medicare-Medicaid partnership to treat all prevalent cases of hepatitis C appears to be cost-effective by saving money and improving patient outcomes.

It is already known that dual-eligible older adults are at an increased risk for death in the year following a stay in the intensive care unit (ICU), but it previously wasn't known whether dual-eligible status is linked with functional decline after an ICU stay.

An author of a study in the May 2021 issue of The American Journal of Managed Care® describes how the COVID-19 pandemic, the aging of America, and already-existing workforce shortages will further threaten the dual-eligible population unless policy makers reform scope-of-practice laws.

New guidelines recommend Americans get screened earlier for colon cancer; Johns Hopkins University will send mental health providers on security calls; Tennessee's governor signs bill limiting health care for transgender youth.

The COVID-19 pandemic brought together the world and taught health systems how to be resilient and adapt to both predictable and unpredictable changes, said the panelists during the plenary on day 1 of Virtual ISPOR 2021.

Genome-wide association studies are building the potential for precision medicine for children with respiratory diseases, but the progress also comes with challenges related to cost and issues with early screening, according to speakers at the ATS 2021 International Conference.

Anthony Fauci, MD, told attendees at the ATS 2021 International Conference that the real-world evidence of vaccines against SARS-CoV-2, the virus that causes COVID-19, is even better than expected.

A pediatric infectious disease expert reviewed some developments in the vaccine development pipeline, especially new efforts targeting infant health through maternal immunizations.

There is a role for pharmacists and pharmacy quality measures in addressing the public health challenge of diabetes, according to speakers at a recent virtual meeting this week.

A voter-passed measure to expand Medicaid coverage in Missouri will not advance; $7.4 billion will soon be available for recruiting and hiring public health workers; the World Health Organization (WHO) is being chastised for its COVID-19 origins report.