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What We're Reading: Health Insurance Coverage and Unecessary Procedures
What we're reading on October 12, 2015: health insurance marketplaces may have challenges keeping customers they already have, but in California, consumers leaving the state insurance exchange are gaining coverage elsewhere, and the government is increasingly pursuing cases of potentially unnecessary procedures.
Insurance Dropouts Present a Challenge for Health Law
Health insurance marketplaces getting ready for the next open enrollment period, which starts November 1, will have the added challenge of keeping customers they already have, reports New York Times. The last open enrollment period ended in February and by the end of June there had been a drop of about 15% in the total number of people enrolled in the federal and state marketplaces.
Read more: http://nyti.ms/1PpQvob
Cincinnati Hospital to Pay $4.1 Million to Settle Claims for Unnecessary Surgeries
The government is increasingly pursuing cases of potentially unnecessary procedures, reports Modern Healthcare. A hospital in Cincinnati will pay $4.1 million to settle government allegations that the hospital was billing Medicare and Medicaid for unnecessary spine surgeries.
Read more: http://bit.ly/1Ms6Fwd
Consumers Dropping Covered California Plans Gain Insurance Elsewhere
The vast majority (85%) of individuals who have dropped their health insurance coverage through Covered California, the state’s health insurance exchange, gain insurance elsewhere. Nearly half of those who do are opting for employer-based coverage, while others are turning to Medi-Cal and private coverage, FierceHealthPayer reports.
Read more: http://bit.ly/1Lm8FFz
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 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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Polatuzumab Vedotin and R-CHP Appropriate for Untreated DLBCL
April 24th 2024Population pharmacokinetic and exposure-response analyses revealed a favorable benefit-risk profilane for the treatment combination of polatuzumab vedotin and rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHP).
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Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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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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