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A new rule from CMS for 2019 would allow for more flexibility in benefit design for Medicare Advantage enrollees with specified chronic conditions.

Here is a preview of 5 of the biggest trial results to be presented at the American Society of Clinical Oncology (ASCO)'s Annual Meeting to be held on June 1 to 5, 2018, in Chicago, Illinois.

From 2000 to 2016, there have been improvements healthcare access and quality improvements around the world, but in some countries, progress has slowed or stalled, and disparities between countries remained similar.

This week, the top managed care stories include the finding that new guidelines will mean the number of people with hypertension will soar; research finds that most diabetes apps don’t lower glycated hemoglobin; and a health plan announced its plan to fight housing instability.

Coverage of our peer-reviewed research and news reporting in the healthcare and mainstream press.

As part of a settlement with the Department of Justice, Pfizer will pay the government nearly $24 million to resolve kickback allegations; both blue and red states worry association health plans could become targets for scam artists; a prototype of a swallowable sensor that can send results to a smartphone app will provide a peek into the digestive system.

The American Diabetes Association (ADA) released a set of policy recommendations designed to spotlight the increasing difficulties patients with diabetes have affording insulin or gaining access to the life-saving medication. The recommendations follow the findings of a working group about the issue, the findings of which were presented to the Special Senate Committee on Aging earlier this month.

Urologists, oncologists, or other specialty physicians should not be judged solely by the same quality measures used by internists when it comes to reporting quality data to CMS, most would agree. Qualified Clinical Data Registries can help with the data submission process and even with the creation of measures that CMS may use when looking at quality measurements specific to specialty areas.

Successful initiatives using private sector data can provide insight into what is needed to power the paradigm shift to price transparency.

Analysis of patient-reported outcomes found patients with relapsed/refractory B-cell acute lymphoblastic leukemia who were treated with inotuzumab ozogamicin reported better quality of life, functioning, and symptom scores compared with patients receiving standard-of-care chemotherapies.

Pairing oxygen with noninvasive ventilation at home for patients with chronic obstructive pulmonary disease (COPD) with persistent high carbon dioxide levels in the blood, who had recently had a life-threatening exacerbation requiring hospitalization, was cost effective, according to results of an abstract presented at a recent medical conference.

A new report from the Congressional Budget Office (CBO) and the Joint Committee on Taxation outlined health insurance coverage losses between 2018 and 2028 for people under age 65 as a result of changes to the Affordable Care Act (ACA) by the Trump administration, as the percentage of those who are uninsured will rise from 11% in 2018 to 13% by 2028.

Recognizing the impact housing status has on health, Kaiser Permanente announced an impact investment of $200 million and is teaming up with mayors and CEOs nationwide to reduce homelessness and housing instability.

As the Congo grapples with a new outbreak of the Ebola virus, HHS Secretary Alex Azar has promised to provide aid if the outbreak spreads; providing workers with free e-cigarettes did not help them quit smoking any more than the usual smoking cessation methods did; hospitals in California that haven’t met targets for safety and quality could be excluded from the state’s insurance exchanges health plans.

Clinical trial data has shown that the drug helped 28.6% of patients achieve glycated hemoglobin of 7.0% of less by week 24 without severe hypoglycemia or diabetic ketoacidosis and also helped participants lose weight.

As the nationwide uninsured rate dropped 35%, from 14.5% in 2013 to 9.4% in 2015, there was a corresponding decline of uncompensated care costs as a share of hospital operating expenses—30%—in all but 2 states, found a report.

As benchmarking is now becoming a part of payment models, practices realize they need comparative data to understand how well they perform relative to their competitors and whether there is room for improvement.

The number of US adults who have high blood pressure could grow by as much as 31 million—and the number of adults who will be recommended for antihypertensive treatment could increase by 11 million—if full implementation of the American Heart Association’s 2017 hypertension guideline is reached.

The “right-to-try” bill heads to President Trump’s desk for signing after passing the House of Representatives; the FDA said certain gene therapies in development can qualify for quicker review, starting with hemophilia; brand-name drug makers have raised prices by double-digit percentages since 2012, with 47 drugs costing Medicare and Medicaid nearly $12 billion in 2016.

Neurological damage begins early in infection, particularly during untreated infection, and worsens with the continued absence of combination antiretroviral therapy (cART). However, initiating cART may halt further deterioration, emphasizing the importance of early cART.

Since the launch of the Blue Distinction Total Care program, it has outperformed 96% of industry quality measures in key healthcare quality and patient health metrics, The Blue Cross Blue Shield Association (BCBSA) announced.

Value-based payment reform provides an opportunity for increased resources and improved short- and long-term health outcomes for children, wrote experts in a JAMA Pediatrics Viewpoint article.

Senior citizens with Medicare prescription drug plans, known as Part D plans, are paying more for generic prescriptions even as the market price of these drugs stays flat, an analysis released by Avalere found, because, over time, the generic drugs are being placed on higher formulary tiers where patients pay more out-of-pocket costs.

While cancer incidence rates have decreased among men, they've remained stable among women and have increased among children; however, there has been an overall decline in mortality rates among men, women, and children.

The rate of those without health insurance was resilient last year at 9.1%, with the latest CDC figures also showing that adults in Medicaid expansion states were much more likely to have health insurance than those without.

Rucaparib, the PARP inhibitor approved for the treatment of ovarian cancer, may have potential clinical benefit for patients with advanced pancreatic cancer and a BRCA1/2 mutation.

Clues to cancer treatments are buried in inaccessible patient records; the Virginia Senate reconvenes Tuesday to discuss a budget plan proposed by Republican leaders that expands Medicaid; California introduces a Senate bill to offer full health coverage to undocumented adults.

Trial results show that patients with hemophilia A with or without factor VIII inhibitors treated with emicizumab-kxwh every 4 weeks can have clinically meaningful control of bleeding.