Policy

A pediatric shot for respiratory syncytial virus (RSV) may not be covered as a free routine vaccine; hospitals fail to comply with payment transparency rules; the fate of abortion pills is in the hands of conservative judges

CDC warns against EzriCare Artificial Tears, which were recalled by the manufacturer; certain weight loss drugs not covered by most payers; Mississippi's Republican governor denies being privately in support of Medicaid expansion.

With the public health emergency soon coming to an end, people covered by Medicaid will encounter new barriers, discusses Dennis Scanlon, PhD, professor of health policy and administration, Penn State University.

The government is allowing Medicare Advantage (MA) plans to delay returning hundreds of millions of dollars or more in government overpayments; a proposed new extension of the Affordable Care Act (ACA) might make birth control coverage more accessible for certain private insurance plans; a study found that students lost around 33% of their school year because of the pandemic’s educational barriers and are struggling to regain that lost time.

The United States possesses the highest infant and maternal mortality rates compared with any other high-income country, even though it spends the most on health care.

An HHS report said that if the Inflation Reduction Act (IRA) had been implemented in 2020, Medicare Part D beneficiaries could have saved a total of $734 million, averaging out to about $500 per member.

A new study estimated Medicare drug price negotiation savings; food benefits provided under the Supplemental Nutrition Assistance Program (SNAP) will return to prepandemic amounts; pharmacies reduce hours to cope with staffing shortages, improve work-life balance.

A new study estimates that prescription of standard-of-care non–small-cell lung cancer (NSCLC) therapies is lower than expected in Medicaid programs, with significant variation between states.

The FDA is relaxing some time-based deferrals for donating blood; new guidance aims to streamline the COVID-19 vaccination process; Congress has been called on to solidify cannabidiol (CBD) regulations.

States in which recreational cannabis is legal see declining codeine prescriptions; the FDA plans to simplify the use of COVID-19 vaccines; state-wide abortion debates ramp up as Congress deadlocks

Medical residents join unions for better pay and working conditions; the World Health Organization (WHO) appeals to China on COVID-19 information; health workers protest in Madrid, Spain.

Greater availability of naloxone spray, including over the counter, may reduce opioid overdoses; vaccination rates drop once again for US children; some experts question the necessity of the updated COVID-19 booster shot.

Differences in use of telehealth between commercial and Medicaid populations during the COVID-19 pandemic are associated with managed care enrollment.

A survey of all Arizona physicians found that accountable care organization, clinically integrated network, or integrated delivery network participation was associated with higher use of health information exchange. However, there are exceptions and important barriers noted.

Expanded health coverage sees an increase in enrollments; Antiabortion activists protest against CVS and Walgreens; $26,500 Alzheimer’s drug limits affordability

The 10 drugs selected for Medicare Part D price negotiation with HHS will be announced on September 1, 2023, HHS said Wednesday.

President Joe Biden expected to renew COVID-19 public health emergency (PHE) one more time; Bristol Myers Squibb and Pfizer are denied by the Supreme Court; funding for the 988 mental health helpline expands inclusivity efforts.

Expanded Medicaid coverage reduced hospitalizations by 17% in the first 60 days of the postpartum period, a study found.

HHS updated guidance for states using Medicaid managed care to manage nonmedical needs; anxieties surrounding new variants rise amidst underreported COVID-19 cases in China, which defended its counts; public health campaigns try new strategies to increase trust and promote immunizations.

The addition of adalimumab biosimilars to formularies can help accelerate realized savings as the blockbuster drug Humira faces competition from multiple biosimilars, including 1 approved interchangeable biosimilar.

The top content published in The American Journal of Accountable Care® (AJAC) covered redesigning health care, value-based care, and novel payment models, like the ACO REACH model.

The editors of The American Journal of Managed Care® reflect on the past year and discuss what they’re looking forward to in 2023.

This year’s most-read articles on women’s health surrounds racial inequalities, barriers to care, and other topics that affect a woman’s quality of life.

COVID-19 vaccines have prevented more than 3.2 million deaths, but the US death rate this year has not declined to prepandemic numbers; Texas Attorney General (AG) Ken Paxton’s office has requested driver’s license records with sex changes from the past 2 years, among other documents, from the Texas Department of Public Safety; even though hepatitis C virus (HCV) is curable, some people who are incarcerated are going without treatment and dying.

The effects of the COVID-19 pandemic were clear in the US national health care expenditure analysis of spending last year, as federal spending dropped, but health care use rebounded in 2021.

Further understanding of effective incentives and disincentives is needed to ensure that evidence-based policy and guidelines regarding tobacco cessation are effectively translated into practice at the patient level.

This article describes the implementation of Medicaid smoking cessation guidance in a large, urban federally qualified health center to examine how state-level provisions translated into clinic-level policies.

The authors describe a novel training program for death certifiers in Pennsylvania, which has been designed to specifically focus on some of the main challenges in the death certification process and resulted in a useful model that can potentially be adopted by other states or municipalities.

The changing landscape of health care during COVID-19 placed focus on increasing accessibility to mental health resources other than the emergency department (ED), with potential savings of over $4 billion in annual costs and improvements in patient outcomes.

Impending cuts to Medicare physician services could have an overwhelmingly negative impact on millions of older patients and individuals with disabilities across the country.