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Quality in Medicare Advantage plans is increasing, and CMS credits the improvement to its star rating system. A growing number of Medicare enrollees are in plans receiving at least 4 out of 5 stars, according to a new fact sheet.

The quality bonus payments tied to CMS' star ratings makes it critical that health plans receive a 4 or better, Jonathan Harding, MD, chief medical officer of the Senior Products Division at Tufts Health Plan, said at the America's Health Insurance Plan's National Conferences on Medicare and Medicaid, and Dual Eligibles Summit in Washington, DC, from September 28 to October 2.

In states that chose not to expand Medicaid eligibility under the Affordable Care Act, residents with a median income of less than $800 a month are now ineligible for coverage assistance while those with more than $2000 a month are eligible for subsidies, according to a report from the Urban Institute.

Blue Cross and Blue Shield of Illinois announces the first specialty intensive medical home program in the state, with the Illinois Gastroenterology Group, the state's largest independent gastroenterology practice, effective September 1, 2014.

Fewer than 15% of physicians routinely recommend HPV vaccination to male patients, according to the study published in the journal Cancer Epidemiology, Biomarkers & Prevention.

Although many providers are looking to implement cloud, big data, social, and mobile technologies within the next 2 years, if they haven't done so already, few healthcare organizations feel their infrastructures are prepared for this evolution of electronic medical records, according to a new study.

A survey by Kaiser Family Foundation projects 13.2% overall growth in Medicaid through fiscal year 2015, but the difference between states that expanded the program and those that did not will be stark. The survey of state Medicaid directors also finds 23 states plan expansion of managed care in the next year.

Those planning to purchase health insurance on the Obamacare exchange will soon find out how much rates have increased-after the November 4 election.

With the enormous amount of data being collected and entered into EHRs, the human brain (in this case the physician brain) is probably tuning out information that would probably stay if there was a conversation with the patient instead.

The American Society of Clinical Oncology has endorsed the joint guidelines established by the 3 Associations to help physicians make evidence-based decisions when selecting patients to administer some of the targeted therapies developed for lung cancer.

Ohio is the latest state to experience a rough transition to managed care in its Medicaid program, according to weekend reports. Delayed payments and service disruptions to fragile patients are among the complaints. Kentucky had a similar bumpy start when it changed to Medicaid managed care in 2011, and Kansas has had many problems recently.

Gilead Sciences' Harvoni represents the first once-a-day, complete treatment pill approved by the FDA to treat the hepatitis C virus (HCV). And for some patients, the drug will be less expensive than Gilead's other HCV treatment, Sovaldi.

Opdivo (nivolumab), which was approved in Japan in July 2014, is being globally developed for evaluation in non-small cell lung cancer (NSCLC), melanoma, renal cell carcinoma (RCC), head and neck cancer, glioblastoma, as well as NHL.

The NDA submitted by Pfizer requests approval of palbociclib as a first-line therapy in combination with letrozole for ER+, HER2- advanced breast cancer.

Reference pricing programs can steer patients to lower-price, adequate quality providers, but potential savings to health plans and purchasers are actually modest, according to a study from the National Institute for Health Care Reform.

Medicaid expansion under the Affordable Care Act has been an overall success for insurers in most states that have implemented it; however, the story is different in Kansas, which switched its entire Medicaid program to a private model.

The new BiTE antibody technology developed by the company can simultaneously engage 2 different targets, which can help recruit T-cells to malignant cells, and will be evaluated in ALL patients.

Despite progress being made, health information technology interoperability remains a struggle, according to a report submitted by the Office of the National Coordinator for Health Information Technology and HHS to Congress.

The approval follows 2 clinical trials evaluating the regimen in 1720 cancer patients receiving chemotherapy.

Without much fanfare, Massachusetts launched a new era of healthcare shopping last week. Anyone with private health insurance in the state can now go to his or her health insurer's website and find the price of everything from an office visit to an MRI to a Cesarean section. For the first time, healthcare prices are public.

With millions of new Medicaid beneficiaries, Federally Qualified Health Centers may not be able to keep up with the increased demand, even with access to federal funding.

The approval extends the use of bortezomib beyond relapsed and refractory patients.

A study conducted at NYU Langone Medical Center finds that unnecessary radiation in cardiac stress tests costs $500 million a year and causes nearly 500 cases of cancer. Greater use of ultrasound or treadmill tests could save money and improve patient safety; however, earlier studies by The American Journal of Managed Care point out possible barriers to these options.

While still being on the receiving end for the high cost of sofosbuvir, Gilead's combination pill for Hepatitis C (sofosbuvir + ledipasvir) was today approved by the FDA.

For the third year in a row, Medicare Part B monthly premiums and deductibles will remain unchanged at $104.90 and $147, respectively, according to HHS Secretary Sylvia Burwell.

There are 10 emerging healthcare trends that will impact managed care pharmacy organizations over the next 5 years as the United States healthcare system places more emphasis on affordability, population health, and patient satisfaction and quality of care, according to a new report from the Academy of Managed Care Pharmacy.

The identification of specific RNA molecules in the urine of individuals with prostate cancer raises hope for a non-invasive test for the disease.

Financial results from the first 2 years of the Pioneer ACO Model reveals the gains and losses of the 32 organizations that started the program, and illuminates why just 19 remain.

The majority of low-income adults in 3 states favored Medicaid expansion, but knowledge about their states' plans for the program under the Affordable Care Act was low, according to a report from the Commonwealth Fund.

Even though roughly 9 million Americans have gained healthcare coverage, other forces related to the "anemic recovery" will keep healthcare spending under control, at least in the short term, writes Charles Roehrig, PhD, in a commentary published online yesterday in the New England Journal of Medicine.