What we're reading, August 19, 2016: CMS is investigating if patients are being steered away from Medicaid and Medicare to private plans; Medicare Part D paid 17% more for drugs in 2014 than in 2013; and 5 things to know about HIPAA today.
CMS is investigating whether providers are steering patients into Affordable Care Act plans instead of Medicare or Medicaid. CMS is concerned that providers or their organizations are paying insurance premiums for patients who quality for Medicare and Medicaid because the provider receive better reimbursements from insurance companies than from the federal health programs, reported The Wall Street Journal. UnitedHealth Group has already sued a kidney-care chain for such alleged actions.
CMS paid 17% more for drugs in 2014 compared with 2013. According to Healthcare Finance, Lantus Solostar and Lantus, both insulin products, had the highest increases year over year, but hepatitis C drug Sovaldi still had the highest total drug costs at $3.1 billion. Under the Medicare Part D program, the government spent $121 billion in 2014. By comparison, while the cost to CMS increased more than 17%, the total cost of claims only increased 3.3%.
This year the Health Insurance Portability and Accountability Act, or HIPAA, turns 20 years old, and things have changed a lot since Congress passed it. With electronic medical records and genomic research, balancing privacy with third-party access to data is difficult. STAT took a look at 5 things to know about HIPAA including that your data is out there, third parties actually have better access to patients’ medical information than the patient does, and medical identity theft is rising.
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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Dr Dalia Rotstein: Physicians Must Be Aware MS Affects People of All Backgrounds
April 24th 2024Dalia Rotstein, MD, MPH, emphazises the importance of awareness that multiple sclerosis (MS) impacts patients from various backgrounds as clinicians think through ways to improve access to care and research efforts in MS.
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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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What We’re Reading: Abortion Privacy Rules; Alzheimer Drug Hurdles; Nursing Home Staffing Overhaul
April 23rd 2024New health privacy rules aim to protect patients and providers in an evolving abortion landscape; some physicians express concerns about efficacy, risks, and entrenched beliefs in treating Alzheimer disease; CMS addresses longstanding staffing deficits in nursing homes.
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Award-Winning Poster Presentations From AMCP 2024
April 23rd 2024At the Academy of Managed Care Pharmacy (AMCP) 2024 annual meeting, multiple poster presentations concerned with health equity, data collection, glucagon-like peptide-1 agonists, and more were acknowledged for their originality, relevance, clarity, bias, and quality.
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