Policy

Capping federal Medicaid spending, raising the eligibility age for Medicare, and bundling Medicare payments to healthcare providers are some of the federal spending reduction possibilities included in a report by the Congressional Budget Office released Wednesday.

Finding a health plan on the Medicare website could be troublesome for some seniors.

Estimates from the nonpartisan Congressional Budget Office are considered the gold standard in Washington.

About 8,000 Washington residents will soon receive letters informing them that the price they are expecting to pay for health insurance purchased on the new online exchange marketplace is incorrect.

Millions of people could qualify for federal subsidies that will pay the entire monthly cost of some health care plans being offered in the online marketplaces set up under President Obama's health care law, a surprising figure that has not garnered much attention, in part because the zero-premium plans come with serious trade-offs.

A multi-part session titled Stroke in Atrial Fibrillation: A Preventable Condition was begun by Michael D. Ezekowitz, MB, ChB, DPhil, of the Lankenau Institute for Medical Research. In his presentation titled All Novel Agents are Preferred to Warfarin, he discussed the benefits of novel anticoagulant agents.

Atrial Fibrillation, the Epidemic of Our Time was the first portion of a multi-part session titled Pharmacological and Interventional Options for Stroke Prevention in Atrial Fibrillation. The introduction, titled Multifaceted Approaches to Atrial Fibrillation: From Drugs to Ablation to Left Atrial Appendage Closure, was delivered by Vivek Y. Reddy, MD, professor of medicine in cardiology at Mount Sinai Medical Center.

The first part of the session titled Innovation in Transition: Models, Global Trends, Regulatory Challenges, and Funding Opportunities started with a presentation from John B. Simpson, MD, PhD, chief executive officer at Avinger, Inc, called Individual-Based Innovation. Dr Simpson briefly described the lumivascular approach to treatment of cardiovascular disease, which is image-guided atherectomy.

The disastrous rollout of HealthCare.gov may have another serious problem: A CBS News analysis shows that in many of the 15 state-based health insurance exchanges more people are enrolling in Medicaid rather than buying private health insurance.

Implementation of ICD-10, or the International Statistical Classification of Diseases and Related Health Problems, 10th revision, is on the horizon. This significant, next-generation change in the health information technology field will be used for everything from billing and measuring quality to managing population health.

Many physicians around the country are getting notices from Advantage plans that they are being cut from private insurers' networks. In addition, some insurers have announced they are reducing their Advantage plan offerings in some states, trimming extra benefits and increasing patient cost sharing.

Hospitals will face growing pressure to reduce costs and improve outcomes as transparency programs reveal comparative performance.

This study identified inefficiencies in drug and medical service utilization related to pain management among Medicare members with osteoarthritis and chronic low back pain.

Seniors need to examine insurance plans carefully to avoid devastating financial surprises. It's not easy, though, as insurance becomes increasingly complex with sometimes widely disparate rules for various scenarios.

Health plans are sending hundreds of thousands of cancellation letters to people who buy their own coverage, frustrating some consumers who want to keep what they have and forcing others to buy more costly policies.

Benefits consultant Aon Hewitt predicted that healthcare premium costs for large U.S. employers would rise about 6 percent in 2013, but when it tallied up its numbers for the year, the increase was only about 3.3 percent.

Dual eligibles-the class of Americans that qualify for both Medicaid and Medicare coverage-are mostly older adults with low incomes and tend to be the sickest beneficiaries covered by either Medicaid or Medicare.

The dynamic landscape of healthcare and managed care pharmacy will be deeply impacted by new and emerging specialty medications. The ever-spiraling costs of specialty medications have led many experts to question whether these treatments translate into true improvements in health outcomes or patients' quality of life.

Not surprisingly, Thomas Merrill, lead researcher, Center for Accountable Care Intelligence, Leavitt Partners, LLC, said that cost is a major work flow challenge associated with Accountable Care Organizations.

In this interview, Curtis Triplitt, PharmD, associate professor and assistant dean of research, Texas Tech University Health Sciences Center, Permian Basin, explains why diabetes should be treated with a patient-centered approach.

Physicians' access to a health information exchange saved more than $1 million in emergency care costs over a one-year period, according to a study released Monday by the American College of Emergency Physicians,

Community health centers will pay a steep price for states' decisions not to expand Medicaid under the federal health law.

Since 2010, the growth and proliferation of accountable care organizations (ACOs) has increased, and the rise of this collaborative care model is not without reason. Lack of consumer engagement, lack of competition, and misaligned incentives have made care less affordable.

Suzanne Tschida, PharmD, vice president, specialty benefits & outcomes, OptumRx, said that at UnitedHealth Group a tiering system is used for the management of specialty medications with a cost-share or copay structure.

Expansion or not, it is obvious that states must consider how to make their Medicaid programs more sustainable.