April 25th 2025
As the Affordable Care Act passed its 15th anniversary this year, Supreme Court Justices continue to deliberate the fate of its preventive services mandate in Kennedy v Braidwood.
Contributor: CMS Can Seize Opportunities to Fix the Rural Glitch, Risk Adjustment Caps in MSSP
October 10th 2021The Medicare Shared Savings Program (MSSP) has seen its growth slow, but CMS has an opportunity to act on proposals that would address benchmarking and more fairly allocate savings to accountable care organizations in the program.
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Contributor: Institutional Engagement With Physicians Is Key to Managing Cost and Quality
September 30th 2021Although physicians’ clinical decisions serve as the biggest drivers behind the cost of care, hospitals have long been reluctant to take financial accountability. If such accountability is to be transformed from a diffuse fear to a manageable managerial task, institutional engagement with physicians will be a critical next step.
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Reviewing Race and Kidney Disease in the NKF-ASN Task Force Report
September 28th 2021On this episode of Managed Care Cast, we speak with Susan Quaggin, MD, FASN, a nephrologist and the chief of nephrology/hypertension and director of the Feinberg Cardiovascular and Renal Research Institute at Northwestern University, as well as current president of the American Society of Nephrology (ASN). She discusses the recommendations of the National Kidney Foundation (NKF) and ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Diseases and what comes next for laboratories, clinicians, and patients.
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Results of a representative study of patients at federally qualified health centers found Medicaid expansion was associated with reduced rates of uninsurance, improved blood pressure and diabetes control measures, and progress in closing racial care disparities over 5 years.
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Remove Race From Equation Used to Assess Kidney Function, Researchers Say
September 23rd 2021Long-awaited reports released Thursday call for eliminating race in estimated glomerular filtration rate equations and point to alternatives in an effort to eliminate disparities in chronic kidney disease.
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PCOS Estimated to Cost $8 Billion in Immediate, Long-term Health Issues
September 21st 2021An updated report shows that the long-term cost of treating the health effects of polycystic ovary syndrome (PCOS)—$4.3 billion—is even higher than $3.7 billion it takes to diagnose and treat immediate issues that present for women who are of reproductive age.
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States Late to Adopt PrEP Risk Falling Further Behind
September 18th 2021A new analysis of 2014-2018 data among all states plus Washington, DC, for those who have either indications for preexposure prophylaxis (PrEP) or current prescriptions for the preventive treatment, shows a widening gap in PrEP uptake, with states considered early adopters pulling ahead of those considered late adopters.
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FDA Committee Votes Against COVID-19 Vaccine Booster for General Population
September 17th 2021The advisory committee voted against COVID-19 vaccine booster shots for individuals 16 years and older, but unanimously voted for booster shots for people 65 years and older or who are at high risk of severe COVID-19.
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Dr Joseph Alvarnas on the Speakers, Sessions to Watch at PCOC 2021
September 15th 2021Looking forward to the 10th anniversary of the Patient-Centered Oncology Care® (PCOC) conference, taking place in a hybrid format September 23-24, 2021, Joseph Alvarnas, MD, of City of Hope, editor-in-chief of Evidence-Based Oncology™, and co-chair of the meeting, discusses the takeaways that attendees can expect to hear about in the areas of patient care, payment and quality, and multidisciplinary collaboration among specialists.
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Could Psychedelics Ease Mental Health Toll From COVID-19, Other Crises?
September 15th 2021The fallout from COVID-19 has spotlighted the limitations of US mental health care, prompting the question if alternative treatments—like psychedelics—could help address current and impending crises.
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Increasing Medicare Annual Wellness Visits in Accountable Care Organizations
Through innovations increasing the ease of scheduling and the efficiency of conducting annual wellness visits (AWVs), a large Medicare accountable care organization has been able to increase AWV rates among eligible beneficiaries.
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Coordination Without Consolidation? Options for ACOs
September 14th 2021Findings published in this issue add to the growing literature showing that multiple types of accountable care organizations (ACOs) can be successful, whether they are confederations of smaller, independent primary care practices or larger, integrated systems.
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Improving Outcomes-Based Managed Entry Agreements for SMA Therapy
September 12th 2021Innovative therapies for rare diseases such as spinal muscular atrophy (SMA), when paid for by public budgets in the European Union and elsewhere, are often managed by agreements between payers and drug companies, but details can be hard to discern.
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Unraveling the Physical, Mental Health Impacts of 9/11, 2 Decades Later: Part 2
September 10th 2021In part 2 of a 2-part series, we look at the mental health risks affecting 9/11 rescuers, the lessons learned that apply to health care workers during the current pandemic, as well as continued barriers to care.
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Back-to-School Virus Watch: Children Are at Risk for More Than Just COVID-19
September 7th 2021Researchers have found that the COVID-19 pandemic has caused potentially millions of children to miss routine vaccines. During a time of back-to-school excitement and reversals of transmission prevention efforts in some states, children may be at risk of facing a slew of non-COVID-19 viral outbreaks.
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