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A checklist to prepare for and submit documents for Merit-based Incentive Payment Program (MIPS) reporting under CMS' Quality Payment Program.

Prior authorizations delay care, have a significant negative impact on clinical outcomes, and place a high burden on providers, according to a physician survey conducted by the American Medical Association (AMA).

Alabama’s proposed plan to institute work requirements in order to obtain Medicaid benefits would fall heavily on mothers, African Americans, and families living in rural communities, according to an analysis by an independent, nonpartisan policy and research center. And because the state has not expanded Medicaid as allowed under the Affordable Care Act, the work requirement would apply only to extremely poor parents.

Negotiations over reinsurance, cost sharing for insurers stall in Hyde Amendment dispute; drug policy experts say more money is needed if leaders want to combat opioids for real; Supreme Court hears free speech case on abortion clinics.

Earlier this month, a team from the Henry J. Kaiser Family Health Foundation traveled to Puerto Rico as well as the US Virgin Islands to assess the recovery of the healthcare system 6 months following Hurricane Maria. What they found is a very mixed situation, with some areas faring better than others, but with much more work remaining before the islands can restore to a state of normalcy. Compounding the problem, the next hurricane season is approaching while the area has not yet recovered from the first one.

In 2014, Maryland and CMS entered a 5-year agreement employing the All-Payer Hospital Model in the state to cut costs while improving quality. According to the year 3 performance data, Maryland has met or is on track to meet all model requirements, saving hundreds of millions of dollars as it lowers hospital readmissions and steers the state away from a volume-based system.

The right-to-try bill, which suffered a surprise 259-140 defeat in the House of Representatives last week, is scheduled for another vote this week. The House Committee on Rules was scheduled to meet late in the day Monday to change the procedure so that it could be passed with just a simple majority, rather than a two-thirds majority, and this time approval seems likely.

The study compared patients taking semaglutide with those taking placebo and liraglutide, which is approved for treatment of obesity.

With much of the nation talking about alternatives to opioids and other medicines for pain relief, including the possibility of using cognitive and mind-body therapies, The Institute for Clinical and Economic Review (ICER) recently released a report about 5 interventions for chronic low back and neck pain, as well as the value of those interventions in chronic low back pain.

ACA insurers posted good results for 2017 after hiking premiums 25%; Virginia inches closer to approving Medicaid expansion as budget talks near; an AIDS researcher is said to be the top candidate to lead the CDC.

Currently, the FDA is evaluating 2 investigational drugs, both of which treat the underlying pathophysiology of hereditary transthyretin amyloidosis.

Patients with acute myeloid leukemia (AML) who were treated at a National Cancer Institute-designated cancer center had a 53% lower risk of early mortality, according to a study published in Cancer.

CMS has finalized a National Coverage Determination (NCD) that covers diagnostic laboratory tests that use Next Generation Sequencing (NGS) for patients with advanced cancer, according to a press release. The finalization comes a few months after the FDA granted approval to FoundationOne CDx, the first-of-a-kind comprehensive companion diagnostic test for solid tumors.

This week, the top managed care stories included Sanofi offering a deal to payers for its cholesterol drug; a “right-to-try” bill is defeated in the House; and a forum of oncology pharmacists discusses “health insurance” versus “healthcare.”

While rates of pre-exposure prophylaxis (PrEP) usage among Americans have significantly increased year over year since PrEP gained approval for HIV prevention in 2012, significant gaps exist among African Americans and Latinos, according to analyses from AIDSVu and the CDC.

If a health system could identify which patients with chronic obstructive pulmonary disease (COPD) were at risk for exacerbations of disease, interventions aimed at improving health outcomes could be developed. A study to develop and evaluate predictive models that could be used to identify such high-risk patients was unable to do so, however.

Ninety-three percent of hospitals and health systems enable patients to access their health data, interact with health data, and obtain health services, according to a report from the American Hospital Association. In a nationwide poll from Ernst & Young, consumers and physicians indicated that they want more digital interaction in healthcare.

Results from the ODYSSEY Outcomes trial for the PCSK9 inhibitor alirocumab were the top news at the meeting.

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

Idaho is still seeking a way to get its state's health insurance plans approved by CMS; a new poll finds that support for action on drug pricing dips when potential ramifications are weighed; senators seek information on hospitals' use of 340B drug discounts.

With the threat of another government shutdown looming next week, Sen. Lamar Alexander, R-Tennessee, formally asked his colleagues in the Senate to reinstate and expand cost sharing reductions (CSRs) in an effort to lower premiums for people who do not qualify for subsidies for insurance bought through the Affordable Care Act. However, it remains to be seen if the effort will work, as a new fight over abortion funding threatens to derail any efforts to stabilize insurance markets.

The FDA has issued an advance notice of proposed rulemaking in a move to lower nicotine in combustible cigarettes to minimal or non-addictive levels.

New health statistics from the US government paint a picture of a population that is more obese and more prone to diabetes than it was 20 years ago. On the bright side, however, more people have health insurance.

A new study recently published in Proceedings of the National Academy of Sciences has identified a possible solution for improving the efficacy of moxetumomab pasudotox, or moxe, in patients with relapsed and chemotherapy-resistant acute lymphoblastic leukemia.

The report finds a connection between payment reform and hospital use patterns, but that connection may add to the debate that cardiologists have raised over the effect on patients.

Rep. Frank Pallone Jr, D-New Jersey, the ranking member of the House Energy and Commerce Committee, wants its chairman to hold a hearing on the growing number of healthcare mergers to discuss what impact they may have on patients, providers, and other aspects of the healthcare system.

The Patient-Centered Outcomes Institute shared results of 5 recent publications summarizing results from their awardees. The studies included research on a decision aid for patients with heart failure, 2 different approaches to treating mental illness, and addressing chronic pain.

An updated cost sharing reduction (CSR) subsidy bill would cut premiums while making programmatic changes to insurance; hospitals are facing shortages of opioids for patients; there's low usage of HIV prevention medicine among minorities, according to new data.

A year has passed since Amy Lansky stepped down as director of the Office of National AIDS Policy (ONAP), and the position continues to remain open, worrying HIV/AIDS advocates.

To achieve a similar capture rate for nonwhite patients as for white patients at age 50, screening ages would need to be reduced to 47 years for black and Asian women, and 46 years for Hispanic women.