Health Care Delivery

CMS cut the amount of money it is awarding to organizations that help individuals enroll in insurance for 2019 plans under the Affordable Care Act (ACA) by $26 million, and, for the first time, is encouraging the so-called “navigators” to also sign people up for health insurance that provides a narrower level of coverage than the plans under the ACA.

Blaming a recent decision by the US District Court for the District of New Mexico, CMS has announced that it has halted collections or payments under the risk adjustment program, including amounts for the 2017 benefit year, established by the Affordable Care Act for the 2014-2018 benefit period.

HHS Secretary Alex Azar appeared before the Senate Committee on Finance today to discuss the Trump administration’s efforts to drive drug innovation and affordability, answering a slew of questions revolving around the "American Patients First" blueprint, increasing generic and biosimilar competition, and value-based pricing.

How many uninsured people in the United States are eligible for coverage under the Affordable Care Act (ACA)? A new analysis from the Kaiser Family Foundation (KFF) found that 14.8 million people could gain coverage, either through Medicaid or by enrolling in a marketplace plan.

A conservative coalition is pushing a plan to repeal the Affordable Care Act (ACA), but centrist Republicans getting ready for the midterm elections have no interest in it; the World Health Organization has unveiled the 11th version of its International Classification of Diseases (ICD-11); doctors in Puerto Rico are seeing a stunning rise in the number and severity of asthma cases that they attribute to destruction caused by Hurricane Maria last September.

A look at telepsychiatry’s rapid expansion into nontraditional settings.

What seems like a straightforward idea—screen current and former heavy smokers for lung cancer—proves more challenging in practice, according to findings from a demonstration project at the Minneapolis Veterans Affairs Health Care System.

The Department of Justice (DOJ)’s legal brief in the Texas case against the Affordable Care Act (ACA) could have far-reaching ramifications besides ending protections for people with pre-existing conditions; 1 in 5 Medicare patients sent from the hospital to a nursing home boomerang back within 30 days, often for potentially preventable conditions; Anthem, Blue Cross Blue Shield of Texas, and UnitedHealth Group are among insurers scrutinizing the cost of emergency department (ED) visits.

Using data from 8 states, the Kaiser Family Foundation is tracking preliminary 2019 insurance premiums in the Affordable Care Act’s marketplaces as rate information is filed with state regulators. The 8 states are Maine, Maryland, New York, Oregon, Rhode Island, Vermont, Virginia, and Washington, plus the District of Columbia.

With few Americans receiving all the preventive services recommended for them, efforts across the full delivery system are needed to increase the use of preventive services, according to a paper published in Health Affairs.

A state judge in Maine ordered Goveror Paul LePage’s administration to stop stalling and implement a Medicaid expansion; the National Institutes of Health reported on a treatment that eradicated cancer from a patient who had untreatable, advanced breast cancer; citing changes to the Affordable Care Act, insurers are proposing double-digit rate hikes for 2019.

A new study published in Health Affairs hopes to provide an explanation of the evidence for the pros and cons of Medicaid expansion as part of the Affordable Care Act (ACA) with a systematic literature review, finding that expansion was associated with increases in coverage, service use, quality of care, and Medicaid spending.

A new study analyzed the burden of multiple myeloma around the world, as well as access to effective treatments. From 1990 to 2016, incident cases and deaths from the disease have grown substantially.

A new report from the Congressional Budget Office (CBO) and the Joint Committee on Taxation outlined health insurance coverage losses between 2018 and 2028 for people under age 65 as a result of changes to the Affordable Care Act (ACA) by the Trump administration, as the percentage of those who are uninsured will rise from 11% in 2018 to 13% by 2028.

Researchers based at the University of Michigan compared patients admitted to the intensive care unit (ICU) in Medicaid expansion states with those in nonexpansion states, focusing on 18 specific conditions identified as severe illnesses that could be avoided through better preventive care.

Terry Kohl, a real estate agent in New Jersey, battled what she thought was indigestion for 6 months and went repeatedly to a gastroenterologist for what she thought was a case of “grumbly gut.” Her "indigestion" led to a coronary artery bypass surgery soon after a trip to Rome left her breathless. Read about how women experience health and healthcare differently as National Women's Health Week draws to a close.

An analysis from the Kaiser Family Foundation of the 2017 financial performance of health insurers found that last year was their best year selling individual-market health insurance since the Affordable Care Act was put into place, even without the cost-sharing subsidies that they lost in the fourth quarter.

Surveys collected as part of the Gallup-Sharecare Well-Being Index found that the uninsured rate increased significantly in 17 states from 2016 to 2017. At the same time, no states reported statistically significant decreases in the uninsured rate. This is the first time since the implementation of the Affordable Care Act that states have reported increases in the uninsured rate.

FDA Commissioner Scott Gottlieb, MD, has embraced the calorie counts at restaurants a year after his agency put them hold on the eve of his arrival. A Nutrition Facts label update is delayed but not scuttled, in contrast with the reversal of school lunch changes from the Obama administration.

Hispanic patients with Medicaid were more likely to be admitted for ambulatory care–sensitive conditions after Nevada’s Medicaid expansion.

Health insurance coverage gains since the enactment of the Affordable Care Act (ACA) in 2010 are starting to weaken and reverse, with the uninsured rate among those aged 19 to 64 increasing from 12.7% in 2016 to 15.5% in 2018.

At the 15th Annual World Health Care Congress, CMS Administrator Seema Verma highlighted new policies and initiatives from CMS to ensure that programs are delivering high-quality care in a sustainable way as healthcare spending continues to grow at a faster rate than the overall US economy.

Bill Gates is offering $12 million in a push for a universal flu vaccine; the number of people sick from the E. coli outbreak rises to 98; and a Representative is proposing automatically enrolling eligible individuals in Affordable Care Act (ACA) and Medicaid plans.

One study revealed that 40% of residents in the South report financial barriers that prevent them from giving patients long-acting reversible contraception, including lack of insurance coverage and the cost of the device, which prevents it from being stocked.

While use of services at federally qualified health centers has increased particularly since the implementation of the Affordable Care Act, the increasing trend started back in 2002, said M. Kristina Wharton, MPH, of the Department of Global Health Management and Policy at Tulane University School of Public Health and Tropical Medicine.