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What We're Reading: More Than Half of Hospitals Will Be Penalized for Readmissions
What we're reading, August 3, 2016: Medicare penalties for hospital readmissions reach a new high; the importance of down-ballot races this election; and Virginia's Bureau of Insurance comes out against the Anthem-Cigna merger.
Medicare will withhold more than half a billion dollars in the next year for hospital readmissions. According to Kaiser Health News, the penalties represent a new high as more than half of the hospitals in the United States reported that more patients than expected returned within 30 days of discharge. The $528 million in penalties is $108 million more than last year’s total penalties. The reason: changes in how readmissions are measured.
In a blog post for The Wall Street Journal, Kaiser Family Foundation’s Drew Altman explains by down-ballet races will matter this election. He pointed to Louisiana and Kentucky, 2 states that recently reversed their positions on expanding Medicaid after new governors were elected. Louisiana’s John Bel Edwards succeeded Bobby Jindal, who had been very opposed to Medicaid expansion. Meanwhile, in Kentucky, Matt Bevin has promised to undo the work of his predecessor, Steve Beshear, who set up one of the most effective state insurance marketplaces. This election year there are 12 gubernatorial races, 3 of which are in states that have not yet expanded Medicaid.
The Department of Justice has filed a lawsuit against Anthem and Cigna for their proposed merger, and another state is saying the deal would hurt consumers. Virginia’s Bureau of Insurance says the merger would be a bad deal for consumers in the state, reported The Washington Post. Anthem is the largest insurer in Virginia and covers more than 22% of the market. Virginia’s state attorney general is among those suing alongside the Department of Justice to block the proposed merger.
Oncology Onward: A Conversation With Thyme Care CEO and Cofounder Robin Shah
October 2nd 2023Robin Shah, CEO of Thyme Care, which he founded in 2020 with Bobby Green, MD, president and chief medical officer, joins hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, to discuss his evolution as an entrepreneur in oncology care innovation and his goal of positively changing how patients experience the cancer system.
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California Aims for Equity by Redefining Cancer Care
December 8th 2023Authors highlight key aspects of the California Cancer Care Equity Act, including its focus on Medi-Cal beneficiaries, the requirement for managed care plans to contract with specialized cancer centers, and the definition of complex cancers.
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Insufficient Data, Disparities Plague Lung Cancer Risk Factor Documentation
September 24th 2023On this episode of Managed Care Cast, we speak with the senior author of a study published in the September 2023 issue of The American Journal of Managed Care® on the importance of adequate and effective lung cancer risk factor documentation to determine a patient's eligibility for screening.
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What We’re Reading: RSV Vaccine Demand; Permanent Contraception; Drug Negotiation Impact
December 8th 2023The Biden administration recently met with manufacturers of respiratory syncytial virus (RSV) immunizations to encourage them to increase access to the vaccine; since the Dobbs v Jackson decision, many patients have been seeking more permanent reproductive health care solutions; a Mathematica analysis showed that Medicare prescription drug price negotiations could have cut seniors’ out-of-pocket costs by nearly a quarter had the program been in effect in 2021.
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Patients With RA in Remission Withdrawing From TNF Inhibition Show Flare Increases
December 8th 2023New data presented at ACR 2023 highlighted the differences in rates of flares and Boolean 2.0 remission rates compared to patients with rheumatoid arthritis who continued a tumor necrosis factor inhibitor (TNFi).
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