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This Week in Managed Care July 23, 2016


This week in managed care, the Department of Justice filed suit to block 2 health insurance megamergers, a poll found that healthcare is not a top issue with voters, and a study reported that patients with cancer and dementia get better end-of-life care.

Hello, I’m Justin Gallagher, associate publisher of The American Journal of Managed Care. Welcome to This Week in Managed Care, From the Managed Markets News Network.

DOJ to Block Managed Care Mergers

According to a report by Bloomberg, the US Department of Justice (DOJ) is ready to file suit to block 2 giant managed care mergers: Aetna’s takeover of Humana and Anthem’s acquisition of Cigna.

The deals were announced last summer after the Supreme Court upheld subsidies created by the Affordable Care Act, which keep insurance affordable for those shopping on the federal exchange, HealthCare.gov.

The American Medical Association and several members of Congress have asked antitrust officials to block the mergers because too many local markets would become uncompetitive.

(Update: The DOJ has filed suit to block the mergers.)

Kaiser Health Tracking Poll Results

If healthcare was the top issue in the upcoming presidential election, Democrat Hillary Clinton would have an advantage, according to the most recent Kaiser Health Tracking Poll.

Results show that more voters trust Clinton and the Democrats to manage the future of the Affordable Care Act. Women trust Clinton more on reproductive health issues, and seniors trust the Democrats more on Medicaid.

The trouble for Clinton, however, is that healthcare isn’t the top issue motivating voters—the poll found that Americans are more concerned about terrorism, gun policy, and the personal qualities of the candidates.

Clinton and Trump have some agreements on healthcare. Both support steps to rein in the cost of prescription drugs. The key difference between the two is the future of the ACA: Clinton wants to keep the law, while Trump wants to repeal it.

For more on the Kaiser poll, visit ajmc.com

Study: Clinical Guidelines Not Followed for Older Breast Cancer Patients

Older women who are treated for breast cancer with aromatase inhibitors are known to be at risk for bone fractures.

Clinical guidelines call for bone mineral testing before treatment begins, and for women to be given antiresorptive therapy to slow down bone loss. But new research shows that even though the risk of a fracture rises with age, the oldest breast cancer patients are least likely to receive recommended screenings and preventive care.

A study of Medicare claims data in the Journal of the National Comprehensive Care Network shows that while two-thirds of patients received baseline testing overall, only 51% of those over at 85 were screened. The use of therapy to protect bones also declined with age.

You can read more in ajmc.com.

Better End-of-Life Care in Cancer, Dementia

Patients with cancer and dementia get better end-of-life care than others who are seriously ill. A new study in JAMA Internal Medicine finds that patients with these conditions are more likely to receive information about palliative care, and they are also more likely to have Do Not Resuscitate orders.

Patients with other conditions heard less about palliative care, and their families reported lower quality end-of-life care. Said lead researcher Dr. Melissa Wachterman, “While there is room for improvement in the quality of end-of-life care for all patients, it is particularly true for patients dying of heart failure, chronic lung disease, and renal failure.”

AJMC Study Finds In-Office Medication Distribution Aids Adherence

Getting medication before leaving the doctor’s office can boost medication adherence, according to a study in the current issue of AJMC. A study from the researchers at the University of Miami found that a point-of-care delivery system led by doctors raised medication adherence by at least 17%. Patients were more likely to take medications to manage blood glucose levels, and to treat hypertension and high cholesterol.

Patients liked the system, researchers say, and because the program emphasized generic drugs, it did not increase costs. For the full study, visit ajmc.com.

For all of us at the Managed Markets News Network, I’m Justin Gallagher. Thanks for joining us.

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