Health Care Delivery

It’s a hotly debated question about healthcare reform: How does Medicaid expansion impact emergency department usage?

Researchers from Tufts Medical Center analyzed findings from 26 studies to determine how drug exclusion policies affect patients and healthcare costs.

Factors such as insurance status and being married are significant determinants of survival compared with race/ethnicity, in patients with multiple myeloma who are less than 65 years of age.

What we're reading, August 22, 2016: freestanding emergency clinics come under increased scrutiny; hospitals are being more open about medical mistakes; and regulations to blame for rising generic drug prices.

While Joe Antos, PhD, the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute, believes that the ACO model is here to stay, he said that the way these organizations operate are likely to change.

A new report by the American College of Physicians sheds light on the harsh truth that being underinsured is as big a challenge as being uninsured. Cost sharing, in particular deductibles, has caused patients to forgo or delay care, including medically necessary services.

This week, the top stories in managed care included Aetna's announcement that it was pulling back its participation on the Affordable Care Act exchanges, the annual meeting of the American Association of Diabetes Educators outlined how existing sites can help roll out the Diabetes Prevention Program nationwide, and hospital leaders gave their opinions on CMS' hospital readmission program.

Since 2005, American Cancer Society has sponsored the Health Insurance Assistance Service, a unique initiative to help cancer patients navigate the private coverage system and to educate policy makers about how coverage works for patients with this serious and chronic condition.

When it comes to health coverage, most Americans face an unnerving reality-they have no idea what is covered under their health insurance policy until after they are affected by illness or disease.

Questions about hospitals or their foundations paying for premiums of sick patients to keep them out of Medicaid are as old as the exchanges themselves.

What we're reading, August 19, 2016: CMS is investigating if patients are being steered away from Medicaid and Medicare to private plans; Medicare Part D paid 17% more for drugs in 2014 than in 2013; and 5 things to know about HIPAA today.

What we're reading, August 17, 2016: Walgreens looks to gamify medication adherence; Aetna warned the Department of Justice that if its merger wasn't approved, it would pull back from exchange participation; and the controversy behind numbers of medication error deaths.

Many accountable care organizations are beginning to adopt various programs or strategies into their framework to increase patient access to behavioral health care, but several challenges remain.

Another large insurer says it can't sustain losses from people who were sicker than anyone imagined. Leaving unprofitable markets doesn't answer the question of how to pay for their care.

What we're reading, August 16, 2016: hospitals are partnering with ride-hailing services to get patients to their appointments; Democrats look to repeal a ban on federal funding for abortion; and Colorado will vote on a right-to-die bill this fall.

This week, the top stories in managed care include news on how Medicaid expansion improved health outcomes of low-income individuals, a report on how physical activity lowers risk of 5 common chronic conditions, and findings on how insurance type impacts health outcomes in cancer.

What we're reading, August 12, 2016: CMS announces Obamacare plans saw a healthier mix of consumers last year; the number of babies born addicted to opioids tripled in 15 years; and the Obama administration will shift funding from HHS to fight Zika.

The future of Accountable Care Organizations is very much undefined, as an ACO right now isn’t working to its full potential. However, Joe Antos, PhD, the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American, is positive that the healthcare system will get there in the coming years.

Panelists Leah Binder; Austin Frakt, PhD; Margaret E. O'Kane, MHA; and Matt Salo discussed the Choosing Wisely campaign, patient engagement, the effects of the Affordable Care Act so far, and more.

What we're reading, August 11, 2016: hospitals are throwing out less-than-perfect organs and refusing transplants; why an increasing reliance on hospitalists is bad for comprehensive care; and removing the roadbloack to marijuana research.

While there is no limit on the number of patients a physician can prescribe buprenorphine when sought for pain, physicians face governmental limitations on prescribing this medication to patients who need it as treatment for opioid addiction, said Kelly J. Clark, MD, MBA, president elect of the American Society of Addiction Medicine. These restrictions have in turn created several patient access roadblocks to the needed medication.

What we're reading, August 10, 2016: mortality rate in the United States declines after 2015's increase; infant death in Texas linked to Zika virus; and Ohio colleges drop student health insurance due to Obamacare provisions.

Health insurance status can have a big impact on a person’s health outcomes after they are diagnosed with cancer, according to 2 new studies published in CANCER.

Medicaid expansion programs in Arkansas and Kentucky were found to be equally effective at improving healthcare access for the target population. Both programs face revisions following the election of Republican governors, who want to add work requirements.

Healthcare may not be the leading focus in the 2016 presidential race, but the candidates agree that there are issues that need to be addressed. This infographic breaks the difference between health policy proposals from Donald Trump and Hillary Clinton.

What we're reading, August 8, 2016: a new Medicare law would require hospitals to notify patients about loopholes in nursing home coverage; e-cigarette makers flooded the market ahead of new regulation implementation; and California bill on nurse-midwife independents causes controversy.

The 2016 presidential race has been mostly about the candidates' personal qualities and less about their policies. But that doesn't mean Donald Trump and Hillary Clinton don't have debate-worthy ideas in their healthcare platforms.

Panelists Leah Binder; Austin Frakt, PhD; Margaret E. O'Kane, MHA; and Matt Salo discussed Medicaid expansion, the medical loss ratio, managing specialty populations, and more during the Healthcare Reform Stakeholders Summit.

In an attempt to appease the Department of Justice and save their proposed merger, Aetna and Humana make deals to sell certain Medicare Advantage assets to Molina Healthcare.

What we're reading, August 4, 2016: a new startup is aiming to move clinical trial data to the cloud; Aetna is informing physicians about the opioid prescribing habits; and Florida deploys a mosquito control team to combat Zika virus.