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The November 2018 issue of The American Journal of Managed Care® (AJMC®) has a special focus on substance use disorder, but its studies also touch on disparities in patient portal adoption and the cost impacts of dementia. Here are 5 findings from the research published in the issue.

This week, the top managed care news included research that showed c​​​​ancer surpassed cardiovascular disease to be the leading cause of death in high-income counties; HHS Secretary Alex Azar announced a new mandatory payment model is coming to oncology; a policy change could make mental health treatment more available.

US health officials said Thursday the number of high school students who reported being current e-cigarette users skyrocketed 78% between 2017 and 2018 to 3.05 million, as the FDA moved to create tougher regulations on e-cigarettes, although the agency did not propose the type of ban that some public health advocates hoped for.

Michigan receives approval to implement outcomes-based drug contracts in Medicaid; in the first 10 days since open enrollment began, 1.2 million people have signed up for Affordable Care Act health plans, which falls short of the 1.5 million people who signed up in the first 9 days last year; new research has found that in states with lax gunshot laws, children are twice as likely to die from gunshot wounds compared with states with stricter laws.

America's Health Insurance Plans (AHIP) released what it said are 12 proposals to help increase affordability for people who buy insurance on the individual market who do not qualify for subsidies. Meanwhile, CMS said 1.2 million people signed up for health insurance during the first 10 days of open enrollment for the individual marketplaces.

As physicians have an essential role in the fight against HIV—leading patients through the care continuum—understanding HIV-related stigma among physicians can inform development of interventions to reduce this stigma and promote positive clinical outcomes.

HHS Secretary Alex Azar declares a public health emergency in California over ongoing wildfires; a new formulary from Express Scripts will encourage drug makers to move away from paying rebates and instead keep list prices low; part of Oscar Health’s expansion efforts has brought the insurer to Florida, but the company has said its efforts are being “stymied” by Florida Blue.

It is already well established that patients with COPD have exacerbations during winter as well as during heat waves in the summer months, and researchers in Germany sought to see which patient groups might be potentially more vulnerable to the effects of climate change in order to see who might need targeted care.

Research presented at The Liver Meeting, held by the American Association for the Study of Liver Diseases, found high rates of adherence, treatment completion, and sustained virologic response among patients infected with the hepatitis C virus (HCV) who inject drugs. These findings led authors to recommend inclusion of this subset of patients in HCV treatment programs.

As a result of increased prevention and improved medical treatment of cardiovascular disease (CVD), and despite increasing rates of obesity and diabetes, cancer has gradually surpassed CVD as the leading cause of death in high-income counties. However, CVD is more likely to be the leading cause of death in low-income counties.

Treatment with the investigational drug crizanlizumab (SEG101) reduced pain in patients with sickle cell disease (SCD) who were experiencing vaso-occlusive crisis according to posthoc results of the phase II SUSTAIN study published online in The American Journal of Hematology. The study found that more than twice as many patients with SCD treated with crizanlizumab did not experience a VOC compared with those treated with placebo.

A law overhauling how the Department of Veterans Affairs (VA) allows patients to seek outside care is falling behind in implementation; new government guidelines about physical activity say adults need a minimum of 150 minutes a week of moderate-intensity physical activity, or at least 22 minutes a day; more judges around the country are mandating outpatient psychiatric interventions, including therapy and medication, instead of hospitalizations.