Health Care Delivery

A pledge made to US Senator Susan Collins (R-ME) to support funding for cost-sharing reductions (CSRs) in exchange for her yes vote on the GOP tax bill fell apart Wednesday, apparently because House Speaker Paul Ryan refused to allow the funding to be included in this year’s spending package, slated to be voted on Friday.

AJMC®TV interviews let you catch up on what’s new and important about changes in healthcare, with insights from key decision makers—from the clinician, to the health plan leader, to the regulator. When every minute in your day matters, AJMC®TV interviews keep you informed. Access the video clips at ajmc.com/interviews.

A Commonwealth Fund analysis found that during the 3-year period, the uninsured rate for adults aged 19 to 64 dropped in all 50 states and the District of Colombia. The majority of states also saw less financial barriers to care and more coverage for children and low-income adults

The FDA plans to crackdown on alternative remedies; Senator Lamar Alexander, R-Tennessee, says his Obamacare insurer fix will be in the government funding bill; Alabama prepares to drop coverage for 7000 children.

Some states are considering implementing their own Obamacare individual mandates; a federal judge blocks a rule making it easier for employers to opt out of contraceptive coverage; Senator John McCain, R-Arizona, will miss tax bill vote, but the GOP should have enough votes.

Speaking at the National Comprehensive Cancer Network Oncology Policy Summit on Redefining Quality Measurement in Oncology, Ronald Walters, MD, MBA, MHA, MS, associate vice president of medical operations and informatics at The University of Texas MD Anderson Cancer Center, emphasized the need to focus on the patient’s preferences and values in cancer care delivery.

New legislation would suspend the Affordable Care Act’s medical device tax for 5 years; teenagers are now more likely to vape or use marijuana than smoke cigarettes; California women can access birth control at a pharmacist without a doctor’s prescription, but are unlikely to do so.

FDA is considering a faster approval process for medical devices; the American Clinical Laboratory Association is suing the federal government over a new reimbursement system; there are 2 Obamacare special enrollment periods that a greater-than-usual number of people could be eligible for.

Health officials are warning of an unusually harsh flu season; Ascension and Providence St. Joseph Health are in talks about a possible merger; and heavy traffic is expected as the final week of ACA sign-ups begins.

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

How counties, cities, and schools are saving money by importing drugs for employees; insurers are finally turning a profit on their Obamacare plans; new report projects the number of Americans with Alzheimer's disease will more than double by 2060.

House Speaker Paul Ryan, R-Wisconsin, is eyeing spending cuts to Medicare and Medicaid; Louisiana's Medicaid program reported lower-than-expected spending and a potential surplus; ACA enrollment continues to climb, but expected to fall short of 2017 due to shorter enrollment period.

The rate of healthcare spending in the United States slowed down last year to levels previously seen between 2008-2015, driven by much slower growth in spending for retail prescription drugs, as well as hospital care and physician and clinical services. Private payers, Medicaid, and Medicare­ also saw lower rates of spending growth.

Senator Susan Collins, R-Maine, makes her tax bill vote contingent on more Obamacare funding; some states are setting up programs to recycle leftover drugs; and pregnant women deal with medication uncertainty.

Researchers at Duke University found there is substantial room for improvement in providing consumers with ready access to healthcare prices online.

Republican leaders begin work Monday reconciling the differences in the Senate and House tax legislation, hoping to send a final bill to President Trump before Christmas. Senate Republicans passed the bill by 51-49 just before 2 am on Saturday.

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

Flu season in North America is off to an early start; exercising regularly might not offset a generally sedentary lifestyle; short-term health plans are being packaged to circumvent Obamacare restrictions.

A look at the millions of tax filers who chose the penalty over insurance coverage; the cost of unnecessary or excessively expensive medical care; Takeda begins the first Zika vaccine trial.

Health insurers warned that giving states the ability to define their own essential health benefits will confuse consumers and undermine the insurance markets.

Physicians’ response to policy changes in the Affordable Care Act show that changing cost-sharing formulas can make a difference, according to results reported by Drs. Joseph Ladapo and Dave Chokshi.

Some states prepare to end the Children's Health Insurance Program with no new funding; shifting healthcare landscape reveals odd partnerships; Affordable Care Act sign-ups slow in third week of open enrollment.

The National Center for Health Statistics has issued its early estimates from the National Health Interview Survey, conducted between January and June 2017. The report presents selected estimates, based on data for 39,480 people in the first 6 months of the year, on health insurance coverage for the US population.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

This week, the top stories in managed care included new hypertension guidelines lowering the threshold for high blood pressure, Trump nominating a new HHS secretary, and many consumers now have access to less expensive ACA plans.

The FDA issued new guidelines to speed up the review process for gene therapies; a new report calculates the potential societal benefits of eliminating the opioid epidemic; and one-third of Americans are unaware that the ACA's open enrollment season has begun.

Study finds 2 competing opioid treatments have similar outcomes; GOP tax bill includes repeal of the ACA's individual mandate; and a study finds a correlation between screen time and depression in teenage girls.

The dependent coverage provision was associated with an increase in total and private expenditures and a decrease in out-of-pocket medication expenditures paid, especially among higher-income groups.

As oncology moves toward more deep diagnostic testing and as standard of care continues to quickly evolve, technology advancements are necessary to continue to improve patient access to clinical trials, explained Amy Abernethy, MD, PhD, the chief medical officer, chief scientific officer, and senior vice president of oncology at Flatiron Health.

While consumers must buy coverage or face penalties under the individual mandate for now, there is speculation that a Trump tax plan could remove this feature of the Affordable Care Act.