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What We're Reading: Policies Needed to Support Prisoner Health After Release
What We’re Reading, July 15, 2016: What can the 7 remaining co-ops do to survive; CMS projects increased Medicare spending per enrollee by 2025; and experts call for policy changes to support the health of prisoners at high risk for HIV.
With the rapid failure of the health insurance co-ops—with 4 more announcing there are shutting doors in just the past 2 weeks—only 7 of the initial 23 will still be operational when enrollment begins in fall of this year. Survival will be the bottom line for the remaining consumer operated and oriented plans, as they are called under the Affordable Care Act, since all of them posted losses in 2015, according to Kaiser Health News. According to Timothy Jost, a law professor at Washington and Lee University in Virginia, co-ops are an important alternative to commercial insurers.
According to the CMS Office of the Actuary, the government will be spending over $10,000 a person. The study, which was published in Health Affairs, says healthcare spending will be 20% of the economy by 2025. With 1 in 5 Americans on Medicare, CMS will spend nearly $18,000 annually per member. The lead author on the study, Sean P. Keehan, an economist at the actuary’s office at CMS, told The New York Times that a significant amount of this spending would be the result of high drug prices and greater use of specialty medications.
A series of articles published in The Lancet by experts from the infectious disease field are appealing for policy changes to improve access to treatment, prevention, and care of prisoners post release—especially for those prisoners who are at a high risk of HIV infections. The articles propose solutions such as harm-reduction and drug treatment programs to reduce disease transmission.
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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