Opting Out of Medicaid Cuts
Certain states may have the opportunity to opt out of Medicaid cuts under the Senate’s new bill to repeal the Affordable Care Act. According to Politico, Alaska, Wyoming, South Dakota, North Dakota, and Montana may be able to delay the new Medicaid financing system in the bill based on their low-density populations. The rest of the states would be moved to the bill’s block grant payment system. The opportunity to opt out would expire in 2026. Alaska’s governor has come out against the bill, while Senator Lisa Murkowski, who voted against previous repeal bills, is currently undecided.
Amazon Is in Talks With PBMs
There have been rumors for a while that Amazon might be looking to get into the pharmaceutical business. Now there are reports that the retail giant is in talks with mid-size pharmacy benefit managers (PBMs) to set up contracts, according to FiercePharma. Amazon could also decide to become an online pharmacy, an integrated PBM, or a distributor for pharmacies. Amazon’s entry into the field could take 18 to 24 months and would significantly shake up the drug business.
Safety Net Hospital Payments at Risk
Hospitals are currently reimbursed for some of the costs they incur from taking care of uninsured patients or those who cannot afford their medical bills through a federal program that is now at risk of expiring. The Disproportionate Share Hospitals payments offset some of the uncompensated care hospitals provide, but a payment cut is slated for October 1, reported STAT. If Congress doesn’t act, a total of $43 billion in payment cuts will start to take effect. Safety net hospitals, which care for some of the most vulnerable populations, will be hit the hardest.
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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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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Homelessness Compounds Hospital Stay Challenges: Study Reveals Prolonged Discharge Struggles
March 28th 2024In this investigation, outcomes of interest were morbidity rate and length of hospital stay or a traumatic injury among a homeless population, and whether age and/or injury severity had an influence on that relationship—with implications for improving the discharge process for these patients.
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FDA Approves Vadadustat for Anemia in Patients With CKD Undergoing Dialysis
March 28th 2024The FDA approved vadadustat (Vafseo), an oral medication, to treat anemia in adult patients with chronic kidney disease (CKD) on dialysis for at least 3 months. This fills a need for a new treatment option as anemia is common in these patients and can significantly impact their quality of life.
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