Health Care Delivery

Millions of Americans may still log on to discover that they aren't eligible for any health coverage at all. And that won't be due to any technical glitch. It's because their state has.

We discuss our concerns about tying physician performance to CG-CAHPS scores and suggest an alternative approach to facilitate translation of service excellence into clinical practice.

By 2020, an estimated 85% of Medicaid beneficiaries are expected to be enrolled in a managed care organization a significant increase from the nearly 50% that are currently enrolled.

The American Journal of Pharmacy Benefits (AJPB) and the Pharmacy Benefit Management Institute (PBMI) today unveiled a strategic partnership between the two organizations, which will provide professionals in the pharmacy benefit management industry with free access to both AJPB and its flagship publication, The American Journal of Managed Care (AJMC).

With the US Food and Drug Administration busier than ever with breakthrough and priority review designations, and the rise of genetic-based treatments offering new hope for patients and families, the pressure is on oncologists to push the limits in care. But if it costs $200,000 to extend life just a few weeks, does that make sense? Are doctors having that conversation? When they do, are patients hearing it? These are the very issues that will be on the table in Baltimore Nov. 14-15 when The American Journal of Managed Care convenes experts from the front line.

The debt ceiling has been raised, and that means that the government will be looking for ways to control long-term budget expenditures, including those for programs like Medicare.

Social security numbers allegedly passed around in clear sight. Page after page of unworkable code. And no clarity on when it will all be fixed. Just another day of trying to log in to healthcare.gov.

Health plans are sending hundreds of thousands of cancellation letters to people who buy their own coverage, frustrating some consumers who want to keep what they have and forcing others to buy more costly policies.

At year's end, Texas will shut down its high-risk insurance pool for some of the state's sickest residents, pushing participants to find private coverage in the federal health insurance marketplace created under the federal Affordable Care Act.

Jeff Goldsmith, PhD, healthcare futurist and analyst, says that the Affordable Care Act (ACA) has significantly impacted healthcare policy, in both negative and positive ways.

Richard Stefanacci, DO, chief medical officer, The Access Group, said that it is necessary for retail pharmacists to break out of their silo. Dr Stefanacci noted that retail pharmacists are being utilized within practices and stepping out of their normal roles.

According to John McAfee one of the main problems with the Affordable Act is its technical shortfalls.

The U.S. administration has a little over a month to fix the technology problems crippling its online health insurance marketplace, or jeopardize the goal of signing up millions of Americans in time for benefits under President Barack Obama's healthcare law, experts said on Thursday.

Expansion or not, it is obvious that states must consider how to make their Medicaid programs more sustainable.

The future of healthcare is shaping into something that looks like it is out of a science-fiction movie: electronic health records, E-prescriptions, big data, and cutting-edge technologies being used in the patient procedures. So why are the healthcare insurance exchanges relying on stone-age processes?

Federal officials say they have identified and can fix the biggest flaws in their online insurance marketplace after an inaugural week marked by system outages and long wait times.

Dan Crippen, executive director of the National Governors Association, says the single biggest issue with state Medicaid programs is its significant impact on state budgets.

Ignore the inevitable startup glitches. The new health-insurance exchanges will work just fine -- in the sense that all government health-care programs work: Many people will ultimately become dependent on them for coverage. That won't mean the exchanges have fulfilled their promise, however.

There's a Medicare prescription-drug coverage abyss that is playfully referred to as the "doughnut hole," though there is nothing sweet or amusing about it.

As the government shutdown drags on, patients and providers are feeling the strain.

From the Physician Quality Reporting System's aim to boost quality measures reporting to the potential for accountable care organizations to transform care delivery, this brief sheds light on these and other key ACA provisions impacting cancer care.

Barry Singer, MD, director, MS Center for Innovations in Care, St. Louis, MO, said that the Affordable Care Act could cause challenges in terms of coverage.

Having access to a computer and the Internet may seem like a basic commodity for most Americans, but for the economically challenged, this is not always the case.

Dartmouth-Hitchcock Medical Center and other New Hampshire hospitals may see an increase of patients and changes in healthcare approach as the Patient Protection and Affordable Care Act goes into effect in the coming months.

If for some reason you're not already drowning in the rough waters of U.S. health policy - what with the Affordable Care Act's health exchanges launching today and Congress and President Obama still duking it out over the four-year-old law upheld by the U.S. Supreme Court - well, you're in luck.

Yesterday, the official website enrolling masses of uninsured Americans into health plans logged 1 million visits.

As the nation faced Day 1 of the government shutdown, federal lawmakers made no progress on funding government operations in the new fiscal year, and healthcare leaders pondered the effects of the budget impasse on patients, providers, researchers and public health programs.

Heavy volume contributed to technical problems and delays that plagued the rollout Tuesday of the online insurance markets at the heart of President Obama's health care law, according to state and federal governments, with officials watching closely for clues to how well the system will work and how many people will take advantage of it.

The country is abuzz with news of the state-based exchanges opening today. For the millions of uninsured, it means they can finally obtain affordable coverage. Yet, a lack of outreach and education about what the exchanges entail has created a missing link between consumers and their ability to make effective decisions.

Whatever HHS officials envisioned for the first day of open enrollment on the health insurance exchanges, they surely didn't expect to face it with more than half of the department's employees furloughed.