Health Care Delivery

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.

Georgia is struggling with people who are able to get health insurance, but not access care; unfortunately, little is expected to get done in Washington, DC, with 2018 being an election year, according to Representative Doug Collins, R-Georgia.

Rural counties in the United States have experienced a decline in the availability of hospital-based obstetric services, dropping from 55% of counties having these services in 2004 to 46% in 2014. This loss can “exacerbate maternal health challenges” in rural areas, according to a study in JAMA.

American workers between the ages of 49 and 57 with at least 10 paid sick days had a significant increase in receiving preventive services, such as a flu shot, checking cholesterol and blood pressure, and a fasting blood sugar test for diabetes.

The role of federally qualified health centers is evaluated in serving uninsured patients and providing need-based, reduced-cost prescription medications in the post–Affordable Care Act landscape.

Three House Democratic leaders introduced a healthcare bill aimed at reversing some of the actions taken by the Trump administration regarding the Affordable Care Act (ACA). Because Republicans currently control Congress, however, the legislation may largely be moot for now.

More than half of physicians find that their patients encounter coverage issues due to inaccurate information included in payer directories at least once per month, according to a survey from the American Medical Association (AMA) and LexisNexis Risk Solutions.

Thirty-six percent of Americans who have health coverage through the Affordable Care Act and 27% of those with Medicaid are pessimistic they will be able to keep their future coverage, according to a new Commonwealth Fund survey of 2410 adults. In addition, most believed all Americans should have the right to affordable healthcare. Those agreeing with that sentiment included 99% of Democrats, 92% of independent voters, and 82% of Republicans.

A proposed rule by the Trump administration to allow association health plans to sell insurance across state lines would shift 3.2 million enrollees out of the Affordable Care Act (ACA)'s individual and small group markets by 2022 and increase premiums, according to a new analysis from Avalere.

Twenty states are suing the federal government challenging the constitutionality of the Affordable Care Act (ACA), since the individual mandate was abolished in the tax reform law signed last December by President Donald Trump. The Tax Cuts and Jobs Act eliminated the tax penalty of the ACA, without eliminating the individual mandate itself, according to the lawsuit filed Monday in US District Court in the Northern District of Texas.

A lawsuit filed Monday by 20 red states argues that the Affordable Care Act (ACA)’s individual mandate—and the law itself—is invalid; President Donald Trump brought up the issue of mental hospitals in a meeting with governors, and the administration said it is "actively exploring" ways to help states expand inpatient mental health treatment using Medicaid funds; an EPA center that distributes grants and fellowships to test the effects of chemical exposure on adults and children will be dissolved and consolidated within the agency.

A new policy report from the Urban Institute examining the effects of the Trump administration’s changes to the Affordable Care Act (ACA) finds that premiums will rise in ACA insurance plans and more people will be without insurance in certain states.

Integrating nonmedical social services with medical services is necessary for the United States healthcare system to address unmet social needs, according to a case study published in Health Affairs.

In response to Governor C.L. “Butch” Otter's executive order allowing Idaho insurers to offer insurance plans that do not comply with the Affordable Care Act, Blue Cross Idaho introduced Freedom Blue, 5 individual health insurance plans.

As the conversation surrounding healthcare spending in the United States persists, topics such as drug prices, increased annual spending, and government funding stay at the forefront. Here are 5 things about healthcare spending that are being currently discussed and addressed.

Shortly after Kentucky announced its new work requirements for the Medicaid program, a lawsuit was brought by residents against the government. Sara Rosenbaum, JD, the Harold and Jane Hirsh Professor of Health Law and Policy and founding chair of the Department of Health Policy at the Milken Institute School of Public Health, George Washington University, explains what other states looking to implement work requirements might face.

Premiums in federally facilitated Affordable Care Act Health Insurance Marketplaces are higher in geographic areas with more concentrated hospitals and physician practices and fewer insurers.

Born as part of the Affordable Care Act (ACA) in 2010, the controversial Independent Payment Advisory Board (IPAB) was eliminated last week as part of the Bipartisan Budget Act of 2018 without ever having been implemented. The IPAB sought to reign in Medicare spending if targets went over certain levels, but it had almost universal opposition from the healthcare and medical communities.

There was a reduced rate of uninsured patients at the time of diagnosis and a shift to earlier stage at time of diagnosis for patients with testicular cancer in states that adopted Medicaid expansion in 2014, according to findings presented at the 2018 Genitourinary Cancers Symposium.

Affordable Care Act (ACA) enrollment was stable in most places despite turmoil; National Institutes of Health research, opioid, and mental health funding see gains in budget deal, but ACA stabilization plan is missing.

Are Medicaid waivers meant to encourage able-bodied adults to work, or a return to poor laws of old? Or are they a means to get states that have not expanded Medicaid to expand? A diversity of viewpoints on these and other topics were on full display during Health Reform X.O: What Now, What Next?, the first session of AcademyHealth’s National Health Policy Conference.

A study released Monday found the Affordable Care Act (ACA) helped lower average out-of-pocket spending (OOP) overall, mainly because of reductions in spending among people eligible for the Medicaid expansion and cost-sharing and premium subsidies on the insurance exchanges. However, premium spending rose, mostly, because of large increases for those with higher incomes, said Anna Goldman, MD, MPA, one of the authors of the JAMA Internal Medicine study.

Maine Community Health Options is seeking $5.6 million from HHS, claiming the department failed to reimburse marketplace insurers for cost-sharing reductions for 2017. Under section 1402 of the Affordable Care Act, an insurer participating in the marketplace is required to offer CSR plans, and in return will be guaranteed reimbursement by the government.

Since the implementation of the Affordable Care Act (ACA), annual well visits among adolescents improved with visits increasing the most among Hispanic adolescents.

FDA approved 46 drugs in 2017, a 21-year high; pilot program tests using home care to reduce emergency department visits; a look at how increasing prices, not increased use of services, has caused American healthcare spending to grow so much faster than peer nations.

Patients with cancer may have more options for oral cancer medications, but high out-of-pocket costs still present a barrier to access, according to a new study in Journal of Clinical Oncology.

The spending bill featured a waiver to avoid Medicare cuts in 2018, before voters to go to the polls in the midterm elections.

Key drug approvals; alcohol cancer link.

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

Finding cancer early is a key step to reducing cancer mortality, and a new study suggests that Medicaid expansion under the Affordable Care Act led to more and earlier cancer detection.