Blue Cross Blue Shield in Massachusetts sets agreement with Tufts Medicine using equity benchmarks; drug prices covered by Medicaid to undergo yearly audit; South Carolina abortion ban headed to governor as Planned Parenthood announces national staff cutbacks to shift resources to the states.
Massachusetts BCBS Enters Equity-Based Contract With Tufts Medicine
Blue Cross Blue Shield of Massachusetts (BCBSMA) has partnered with Tufts Medicine to create a value-based payment structure with equity benchmarks, according to Fierce Healthcare. Under this program, Tufts Medicine will be rewarded by BCBSMA for achieving specific goals related to reducing inequities in care for colorectal cancer screenings, diabetes care, hypertension, and child and adolescent well-care visits. The initiative aims to improve healthcare affordability, accessibility, and equity, and is part of BCBSMA's broader effort to address racial and ethnic disparities in health care.
CMS to Conduct Yearly Audit of Drug Prices in Medicaid
The Biden administration announced plans to conduct an annual audit of drug prices charged on high-cost prescriptions covered by Medicaid, according to The Associated Press. As part of the proposal, drug manufacturers would be required to provide proprietary and non-proprietary information to the CMS to support the prices they charge states for Medicaid coverage. Although CMS does not have the authority to enforce price changes, the initiative aims to address rising drug prices and improve transparency.
South Carolina Passes 6-Week Abortion Ban, Advocates Push Back
South Carolina’s Senate has approved a bill prohibiting abortion after 6 weeks of pregnancy, significantly limiting access to the procedure in the state, according to The New York Times. The bill, which now awaits the signature of Republican Governor Henry McMaster, includes requirements such as 2 in-person doctor visits and ultrasounds for women seeking abortions. Abortion rights advocates plan to challenge the ban in court. Separately, Planned Parenthood announced that it will begin cutting back on staff at the national level to shift resources to state battlegrounds, according to The Hill.
The Biden administration recently launched the Global Health Security Strategy, a new effort to combat the spread of infectious diseases; lawmakers zeroed in on the risks of massive consolidation in health care during the first congressional hearing on the Change Healthcare hack; the FDA recently announced the recall of a pair of heart devices linked to numerous deaths and injuries.
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Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
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Study Highlights Disparities in Access to In-Network Mental Health Care vs Medical Care
April 17th 2024While health plans often employ reimbursement rates as a tool to incentivize provider participation within their networks, study results showed reimbursement rates for office visits with medical/surgical clinicians were on average 22% higher than behavioral health clinicians.
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