Health Care Delivery

Top managed care stories this week included UnitedHealth reporting larger-than-expected losses on Affordable Care Act health plans, new guidelines from the government that will improve patient access to medical records, and new information that can reduce risk of diabetes.

A program for homebound patients reduces spending and improves care in high-risk older Medicare beneficiaries.

The profile of high-cost patients in a Massachusetts ACO differed greatly, depending on their enrollment in Medicare, Medicaid, or a commercial plan.

Presenting patients with a one-page handout of information on additional interventions and data on the low value of a service did little to dissuade patients choosing to use a low-value service.

After pressure from insurers over concerns of rising costs, the government is eliminating several special open enrollment periods and will provide stronger enforcement of the remaining special open enrollment periods.

What we're reading, January 22, 2016: the average premium under the Affordable Care Act rose to $408 before tax credits; seniors will face higher Medicare Advantage premiums with a merge between Aetna and Humana; and Hawaii could be the first state to offer long-term care benefits.

A look at healthcare utilization and experience for high-need patients in 9 high-income countries.

What we're reading, January 20, 2016: UnitedHealth losses on Obamacare health plans steepen; more "skin in the game" doesn't necessarily result in savvier shoppers; and despite recommendations few high school students are tested for HIV.

The new rule has implications for personalized medicine, because having access to records helps tailor treatments for everything from cancer to chronic conditions.

What we're reading, January 19, 2016: the Obama administration is looking to make it easier for patients to access their medical records; a clinical trial has left 1 brain dead and 4 hospitalized; and hospitals are experimenting with mobile technologies to track patient health at home.

Radiologists and breast cancer specialists disagree with the US Preventive Services Task Force recommendation of raising the age of screening mammography to 50 years.

Just hours before Bernie Sanders (I-VT) took the stage to face off against Hillary Clinton for the last Democratic presidential debate before the Iowa caucus, the senator released an outline of his single-payer healthcare plan.

Healthcare coverage among parents has increased, but many remain unable to afford coverage.

Cost sharing for marketplace plans remained essentially unchanged from 2014 to 2015, but stable premiums during the period do not reflect the greater costs borne by enrollees, according to a report from The Commonwealth Fund.

People who are purchasing health insurance under the Affordable Care Act may be leaving money on the table because they choose plans with less expensive premiums and miss out on government subsidies, said Sara R. Collins, PhD, vice president of Health Care Coverage Access at The Commonwealth Fund.

This week in managed care the top stories included the announcement of a initiative to cure cancer, pharmaceutical company executives brushed off public outrage over drug prices, and the president's nominee for FDA commissioner has passed his first hurdle.

A new study published in JAMA Pediatrics stressed the importance of providing a variety of health coverage options for children under the Affordable Care Act.

The largest US hospitals are hardly using hospital-based mobile apps, and are thus missing opportunities to engage patients.

What we're reading, January 15, 2016: new report finds flaws in how the FDA tracks drugs after they reach the market; rate of uninsured Hispanic children hits historic low; and CVS and New York State make medication that reverses opioid overdose available without prescription.

What we're reading, January 14, 2016: President Obama proposes extending financial assistance for new states expanding Medicaid eligibility; Hillary Clinton goes hard after Bernie Sanders on single-payer healthcare; and health information exchanges reduce repeated imaging procedures.

Millions of unpaid family members care for elderly parents or relatives. But as baby boomers age, the government faces a quandary because there will be fewer adults age 45 to 64 available to fill that role.

Access to testing for early diagnosis of chronic conditions, and use of data to find care gaps, will reduce health disparities.

An infographic that looks at 3 factors impacting diabetes care, based on the keynote speech from Patient-Centered Diabetes Care 2015 from Robert A. Gabbay, MD, PhD, of Joslin Diabetes Center.

Both patients and hospitals in states that expanded Medicaid benefited from the wider eligibility.

A recent study analyzed screening procedures of community health centers and was able to quantify the screening gap for hepatitis C according to gender and race/ethnicity.

Tele-ICU has been part of a model of care that has tremendous potential to positively affect patients and their families; however, the concept of tele-ICU still faces a few challenges.

Rates of uninsured dropped faster than almost anywhere in the nation, but Kynect is part of "Obamacare," and the new Republican Governor Matt Bevin has vowed that it must go. Advocates have a lot of questions about how hard-to-target populations will be reached and whether grant funds will have to be repaid.

At the J P Morgan Healthcare Conference, Express Scripts' president Tim Wentworth shared the solutions being developed by the pharmacy benefit manager to improve patient access while reducing cost to payers.

What we're reading, January 12, 2016: 43,000 people will lose their Affordable Care Act tax credits for failing to file a 2014 tax return; Kentucky's new governor will dismantle the state's health insurance exchange; and deciding whether to get that medical test.

Affordable Care Act marketplace assisters played a vital role in helping millions of people gain access to healthcare coverage during the first 2 open enrollment periods, a study in Health Affairs finds.