Policy

To be sustainable and successful, Medicare alternative payment models (APMs) have to attract and retain high and low performers. That requires a different approach to pricing and evaluation.

On this episode of Managed Care Cast, we speak with the chief strategy officer for Well Being Trust, one of the authors of a recent report about how well health insurers and state Medicaid programs are covering mental health care for children and compliance with federal law. We discuss the unique challenges that youth face, the health disparities, racism, and community trauma that has been experienced in the past year, and some creative ways that organizations and communities can consider increase access to mental health supports.

During her opening plenary at the NAACOS Spring 2021 Conference, Liz Fowler, PhD, JD, deputy administrator and director of the Center of Medicare and Medicaid Innovation, highlighted how the center is taking a pause to reassess its models and what is coming next.

The study, on the quality of on-demand video telemedicine services, found that patients using telemedicine for respiratory infections were more likely to receive follow-up care, causing higher health care spending.

Changes to naming conventions and interchangeability labels are just some of the regulatory barriers standing in the way of biosimilar uptake, according to Kaiser Permanente researchers.

With President Joe Biden marking his 100th day in office at the end of the month, a health policy strategist sat down for a conversation to discuss the new administration’s achievements and challenges.

Study quantifies risk of blood clots in patients with COVID-19; Biden administration aims to reverse restrictions on fetal tissue research; Michigan hospitals struggle to care for COVID-19 cases.

A new study finds high rates of suicide among female nurses in the United States; President Joe Biden aims to undo Trump-era restrictions on abortion referrals; research indicates regular exercise may prevent severe COVID-19 outcomes.

The CDC's Advisory Committee on Immunization Practices (ACIP) declined to change the current recommendation to pause administration of Johnson & Johnson's COVID-19 vaccine.

Compared with when Medicare Part D launched, therapies today are more expensive. A panel at the Academy of Managed Care Pharmacy 2021 meeting discussed how the benefit needs to adapt to keep up with the future.

PIE, or a preapproval information exchange, is aimed at streamlining payer and health plan involvement so that it happens at the same time a drug developer submits an application to the FDA, instead of after a drug is approved, with the intent of speeding patient access to therapies.

Neglecting public health in state budgets for more than 10 years created an environment that was ill-suited to deal with the challenges of COVID-19 as well as other issues. On this episode of Managed Care Cast, we speak with one of the authors of a recent paper that examined state funding trends from 2008 to 2018 and discuss what could be done in the future to avoid past mistakes.

Low-density lipoprotein cholesterol (LDL-C)–lowering therapies have yielded significant value to society through reduced costs for both fatal and nonfatal cardiovascular disease events. The vast majority of this value has accrued to patients.

On day 2 of this year’s Community Oncology Conference, a panel of government and health policy experts gathered to discuss the hot-button issue of political influence on cancer policy and the damage community oncology has suffered this past year.

Officials urge the Biden administration to track COVID-19 deaths among health care workers; the B.1.1.7 variant is now the dominant strain in the United States; pandemic results in steep declines in STD testing.

Anemia, which occurs in over 50% of patients with end-stage kidney disease, should not be considered an obstacle to home dialysis, according to a new report.

Phase 3 data show the Pfizer/BioNTech vaccine is effective at preventing COVID-19 6 months after the second dose; the USDA will not move forward with a plan to cut food stamps; data reveal spike in drug overdose deaths during pandemic.

To mark the beginning of National Minority Health Month, The American Journal of Managed Care® (AJMC®) takes a look at racial inequities in the COVID-19 vaccine rollout and speaks with one expert who fears reality is worse than data indicate.

Early on in the pandemic, Cotiviti developed a COVID-19 tracker map that accurately predicts where in the United States new COVID-19 outbreaks would occur. Nicole Neumarker, of Cotiviti, provides insight into what impact this technology could have in the future.

Accelerated approval drugs account for less than 1% of Medicaid spending, but states seek CMS approval to avoid coverage of these drugs and cut costs.

Anita Makkenchery, MD, MPH, and Brandy Farrar, PhD, discuss the potential for community health workers to become a regular part of the health care system in a post-COVID-19 world.

Although the FDA has approved 599 orphan drugs since 1983, patent laws and other exclusivities keep most from any competition.

The bipartisan bill spells out 5 step therapy exemptions for patients by amending the Employee Retirement Income Security Act of 1974.

As the first quarter of 2021 ends, patients choosing to keep using secukinumab may be offered an inducement to switch to another biologic, ixekizumab.

President Biden outlines new vaccine goal; the United States will stop distributing Eli Lilly's bamlanivimab; rates of human papillomavirus (HPV) decrease among females.

The announcement allowing the administration of COVID-19 vaccines in dialysis centers is part of a larger $10 billion investment, largely funded by the American Rescue Plan, to expand access.

Survey responses of 320 US hospitals highlight the dire consequences of the COVID-19 pandemic on facilities and point to a future of ongoing financial and staffing challenges.

How can health care systems talk about the issue of COVID-19 vaccine hesitancy with their patients? On this episode of Managed Care Cast, Pat Salber, MD, MBA, of The Doctor Weighs In, interviews the developer of interactive, people-centered, multimedia, educational programs for Wolters Kluwer Health.