Health Care Cost

The rate of uninsured Americans will rise to 8.9% over the next decade; Senator Bernie Sanders (I, Vermont) wants a government watchdog to investigate why women are still being charged for contraception considered free under federal law, and proposed Medicare Advantage Star Ratings target top performers.

June 19 is marked as World Sickle Cell Awareness Day, granting the opportunity to reflect on the current state of treatment, access, equity, and more that impacts patients living with sickle cell disease.

The home-based care model offers a promising strategy for improving quality of care, while also reducing health care spending.

Over $3 billion in payments were issued to health care providers and suppliers; a recent poll highlights growing demand to alleviate medical debt; preliminary data show a decrease in uninsured individuals since 2019.

Ageing with HIV comes with greater risks of other health complications; behavioral counseling programs for obesity are scare and often not covered by insurance; the surgeon general is calling for legislative action to protect youth when they interact with social media.

Adolescent anterior cruciate ligament reconstruction surgery can preserve health and restore function of the knee joint, but the surgical cost has outpaced inflation.

The arrests of the founders of Done Global, a telehealth company that provides attention-deficit/hyperactivity disorder (ADHD) medication to adults, for allegedly providing prescriptions to unqualified patients and defrauding the government have raised concerns about future access to these medications; US health care spending rose to $4.8 trillion in 2023; bipartisan legislation has been introduced to reform prior authorization with Medicare Advantage.

The authors explore the economic impact and accessibility challenges of new Alzheimer disease drugs under the Inflation Reduction Act, with emphasis on Medicare, pricing, and health care equity.

New estimations show a historic increase in health spending last year, which is projected to account for 19.7% of the gross domestic product by 2032.

This study reports qualitative findings from an explanatory sequential mixed-methods investigation to understand hospitals’ approaches to a novel commercial episode-based reimbursement incentive program.

During the CMS Health Equity Conference, health care leaders shared groundbreaking strategies to integrate health equity into value-based care models, aiming to enhance patient outcomes and reduce costs.

Jeff Levin-Scherz, MD, MBA, population health leader at WTW, explains that obesity care in the US is inconsistent and costly, with significant gaps across Medicare, Medicaid, and employer-based insurance.

A dose escalation strategy for regorafenib could improve the cost-effectiveness of the medication in metastatic colorectal cancer (CRC).

This cross-sectional analysis of commercially insured delivering mothers suggests that greater out-of-pocket spending is incurred when pregnancy spans 2 years, causing them to face out-of-pocket limits twice.

Uninsured rates among minority groups plummeted between 2010 and 2022; Democrat lawmakers are challenging drug patents that they believe are deliberate attempts to eliminate low-cost, generic competitors; the National Institutes of Health (NIH) is piloting a nationwide network for primary care research.

The Bundled Payments for Care Improvement program was associated with improved quality of skilled nursing facilities in hospital referral networks for patients undergoing surgery for joint replacement.

FDA advisers have voted against the use of MDMA as a post-traumatic stress disorder (PTSD) treatment; House members have expressed support for the 340B drug discount program but disagreed on whether it needs tighter regulation; a federal judge sided with SCAN Health Plan over CMS about incorrect 2024 Star Rating calculations.

Expansion of Medicaid coverage will now include all-in-one mental health and substance use clinics; 61% of adults are estimated to have cardiovascular disease (CVD) by 2050; the FDA has taken a historic step in potential psychedelic drug approval.

Fauci’s first testimony since leaving government service set to address alleged misconduct and pandemic management; vaccine makers advised to focus on JN.1 and derived subvariants; AstraZeneca and Boehringer Ingelheim introduce $35 monthly cap on inhalers.

Attendees packed a session on multicancer early detection (MCED) on the first day of the 2024 American Society of Clinical Oncology annual meeting.

Glofitamab is currently being investigated in a phase 1/2, multicenter, open-label, dose-escalation study as monotherapy and in combination with obinutuzumab, following 1-time fixed-dose pretreatment with obinutuzumab for B-cell non-Hodgkin lymphoma, of which mantle cell lymphoma (MCL) is a rare type.

This week, the Center on Health Equity and Access covers news related to AI integration, disparities in pediatric hospitalizations, new advancements presented at the 2024 CMS Health Equity Conference, and an expert discussion on the cardiovascular field.

There are effective strategies that can be employed concurrently to promote adherence to medications for schizophrenia, including but not limited to pharmacological, technological, and psychosocial interventions.

Data presented at the recent American Thoracic Society 2024 international conference identified the top barriers to lung cancer screening in Asian Americans, and common risk factors among this population.

Presenters from CMS and the CDC explored the importance of standardizing health equity data collection at the 2024 CMS Health Equity Conference.

An analysis that overviewed dermatologic mobile apps with artificial intelligence (AI) features led researchers to voice concerns about the use of this technology in its current state.

Using a microsimulation approach, this study modeled the potential multiyear health and economic benefits of participating in cardiometabolic virtual-first care programs.

This study quantified the trends over time in utilization of, spending on, and access to CT fractional flow reserve, the first artificial intelligence (AI)–enabled clinical software reimbursed by Medicare.

This international study, incorporating data from the US, Brazil, Singapore, and Spain, shows that durvalumab as maintenance therapy for use against non–small cell lung cancer remains a cost-prohibitive treatment option.

In this episode of Managed Care Cast, Nihar Desai, MD, MPH, cardiologist and vice chief of Cardiology at the Yale School of Medicine, discusses therapies for cardiovascular conditions as they relate to patient adherence, polypharmacy, and health access.