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A one-minute look at managed care news during the week of March 16, 2015, including bills from Congress to fix the sustainable growth rate formula and anticipation over the PCSK9 inhibitors.

An experimental drug for Alzheimer's disease sharply slowed the decline in mental function in a small clinical trial, researchers reported Friday, reviving hopes for an approach to therapy that until now has experienced repeated failures.

New analysis from Avalere finds that the proportion of Medicare Advantage beneficiaries enrolled in plans with 4 or more stars climbed from 38% in 2014 to 60% in 2015.

A bipartisan coalition in the House and Senate introduced identical bills that repeal Medicare's notorious formula for setting physician pay and, have implications for health information technology.

Zarxio was approved earlier this month, the first biosimilar to be approved in the United States.

Opinion on the Affordable Care Act still breaks sharply along partisan lines, making the prospects for even technical fixes unlikely, much less a major change that might be needed in the wake of a ruling in King v. Burwell that would take away premium subsidies in states without their own exchanges.

CMS released its proposed rules for Stage 3 meaningful use for the Medicare and Medicaid Electronic Health Records Incentive Programs. The proposed rules will include greater flexibility and drive interoperability, according to HHS.

By using a lottery to assign coverage, Oregon had unintentionally created the perfect conditions for a randomized controlled trial that could reveal the true costs and benefits of health insurance.

The company said results from a study of European men are consistent with prior studies of men with early prostate cancer that were conducted in the United States.

The study, conducted by Elissa Ozanne, PhD, at Dartmouth found that 11 of the 15 women, aged 45-79 years, interviewed before and after using the mHealth tool preferred it to a paper tool and found it easy to use.

Payers, oncologists, and oncology policy experts provide their feedback on the Oncology Care Model developed by the Centers for Medicare and Medicaid Innovation, which aims to link payment to the quality of care, improve access to care, and enhance information sharing.

Patients need transparency if another surgeon will be consulting on their procedure so there are no surprises. The authors suggest payers should extend emergency provisions to intraoperative consultations when complications arise. The movement toward bundled payments will reduce the chance for out-of-network bills, as hospitals will divide payment.

Patients enrolled in plans on the public health insurance exchange filled more prescriptions than commercial members during the first year of enrollment under Affordable Care Act, according to a report from Prime Therapeutics.

Physician practices looking to engage in new healthcare payment models reported they need help and guidance to further advance delivery reforms, according to a joint study from the RAND Corporation and the American Medical Association.

"It's so ironic that CMMI, the innovation arm of CMS, is trying to sell us on implementing a new payment model for oncology while community oncology practices are struggling financially to keep their doors open because of CMS payment cuts," said Ted Okon, executive director, Community Oncology Alliance.

The agreement would put an end to 17 straight fixes to the sustainable growth rate that have not found a permanent solution for addressing the Medicare cost cuts envisioned in the original legislation.

Training sessions with a psychologist, in women treated for breast cancer, helped women with their memory and to maintain their ability to pay attention to things-the so called "executive function and planning" activities.

The paper, published in the latest issue of the Journal of Economic Perspectives, found that while drug price was related to quality improvement over existing therapies, the price increase surpassed quality.

Using plan data as of November 2014, researchers at the Urban Institute determined that the national average premium increase was 2.9% over the previous year with the South experiencing the largest increases.

Mental health advocates say Florida ranks near the bottom of states for spending on mental health. Bills introduced last week would draw down more federal Medicaid dollars to increase payments to providers, expand services, and prevent those at risk from ending up in prison. The system also has limited experience with managed care.

For the last 17 years Congress has passed temporary 1-year fixes to prevent the Sustainable Growth Rate from enacting steep cuts to Medicare payments. This year, Congress is again flirting with the possibility of creating a permanent fix.

Developed at the Cancer Therapy & Research Center at The University of Texas Health Science Center at San Antonio, the technology uses tiny radioactive liposomes, inserted directly into a tumor with a thin catheter. The first-in-human trial was just initiated.

Researchers have discovered one way in which melanoma becomes resistant to a particular form of targeted therapy, and understanding this phenomenon may lead to a new melanoma target or prompt new designs of these treatments, they say. The results were published in the journal Clinical Cancer Research.

The study, published in Health Affairs, analyzed results from 27 trials that evaluated the influence of health information exchange (HIE) on efficiency, costs, and patient outcomes. The study does not undermine the impact of HIE; rather it challenges users to improve the efficiency of the system.

Millions more Americans have become exposed to another cyberattack on a health plan as Premera Blue Cross announced it had been the target of a sophisticated attack to gain access to its information technology systems.

The fine is a result of the company falsifying sales price data to Medicare. In addition to the fine, Sandoz has to provide evidence that it has established a government pricing compliance program.

Since open enrollment began in October 2013, 14.1 million adults have signed up for health insurance with an additional 2.3 million gaining coverage through the provision covering young adults.

The cost of treating the hepatitis C virus with newly approved therapies could total $90 billion over the next 5 years, representing 6.6% of the country's annual prescription spending.

Powerful cholesterol-fighting drugs, PCSK9 inhibitors, could break new ground for payers: a higher-priced therapy could replace generic statins for patients suffering a chronic condition, perhaps for an unspecified period of time.

The report by IMS Institute for Healthcare Informatics says countries that use a QALY formula to assess cost-effectiveness have less access to new cancer drugs compared with countries that use an alternative system.