Seema Verma, administrator of CMS, is looking to make broad changes to Medicaid expansion without Congress’ help. According to STAT, Verma is looking to cut enrollment and costs for the program, which was expanded under the Affordable Care Act (ACA). She also plans to loosen rules for states to get waivers to make changes to their Medicaid programs. Some opponents are concerned that more leeway with Medicaid waivers could undermine access to care.
A federal judge has blocked a petition from several states to order a restraining order against the Trump administration for ending the ACA’s federal subsidies to insurers. The judge ruled that an emergency order compelling the White House to pay the subsidies was “counterproductive” since states had already prepared for the administration to cancel the payments, California Healthline reported. The lawsuit had been brought by 18 states and the District of Columbia, and the judge’s ruling only applies to the restraining order request. He did not weigh in on whether the funds for the subsidies had been properly appropriated.
After severely cutting back on its ACA business, Anthem is now reporting its ACA business has broken even. Reuters reported that Anthem’s outlook, which forecasts a slight profit for 2018, takes into account lost subsidies that were canceleld by the Trump administration. Anthem’s exit from some ACA markets means it will have reduced enrollment by 70% next year. Another reason why Anthem has been able to break even is that its consumers have been healthier, which has lower medical costs.
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
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Homelessness Compounds Hospital Stay Challenges: Study Reveals Prolonged Discharge Struggles
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FDA Approves Vadadustat for Anemia in Patients With CKD Undergoing Dialysis
March 28th 2024The FDA approved vadadustat (Vafseo), an oral medication, to treat anemia in adult patients with chronic kidney disease (CKD) on dialysis for at least 3 months. This fills a need for a new treatment option as anemia is common in these patients and can significantly impact their quality of life.
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