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.
Dermatologists Looking to the Future Will Need to Be Their Own Advocates, Panel Says
March 21st 2023A panel assembled at the American Academy of Dermatology 2023 Annual Meeting encouraged the audience of dermatologists to advocate together for needed changes in payment, access, and practice.
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Dermatology Data Can Direct Policy Priorities, but Gaps Reflect Inequities of Care
March 18th 2023Speakers at the American Academy of Dermatology 2023 Annual Meeting highlighted the potential of DataDerm to tell the story of dermatological care in the United States, but some also cautioned that the registry only reflects those who have access to care in the first place.
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Biden Administration Releases Drug Rebate List, Promotes End of Vaccine Cost Sharing
March 15th 2023The Biden administration released the list of 27 Medicare Part B drugs that are subject to rebates back to the government for having price increases that rose faster than inflation as well as the removal of out-of-pocket costs for some vaccines covered under Part D.
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Community social determinants of health such as rurality and low socioeconomic status moderate the association between an individual’s race and emergency care use.
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Development of a Medicare Plan Dashboard to Promote Health Equity
Health plans use data to decide on quality improvement initiatives. Having a dashboard that characterizes how equitably plans are serving their enrollees would promote health equity.
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What We’re Reading: Rare Disease Drug Approved; Congress and PBMs; FDA Panel Splits on RSV Shot
March 1st 2023The FDA approved the first drug for the rare disease Friedreich’s ataxia; House Republicans seek information from pharmacy benefit managers (PBMs); FDA panel narrowly supports respiratory syncytial virus (RSV) vaccine for older adults.
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Association Between Use of Clinician Performance Information and Patient Experience
High patient experience scores were associated with the collection and use of any clinician performance information, especially with whether the practice shared this information internally to compare.
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Social Security and Medicare spending could double by 2023; FDA panel experts want naloxone to be available over the counter after the drug information is revised; Moderna announced its COVID-19 vaccines will stay free, and the Biden administration might keep tests and treatments free for the uninsured.
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CMS Practice Assessment Tool Validity for Alternative Payment Models
Using data from 632 primary care practices, the authors show that the CMS Practice Assessment Tool has adequate predictive validity for participation in alternative payment models.
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Addressing Maternal Mortality in Medicaid by Focusing on Mental Health
February 15th 2023On this episode of Managed Care Cast, we speak with Inland Empire Health Plan, a managed care plan serving more than 1.4 million residents on Medi-Cal in California, about a new maternal mental health program aimed at supporting new mothers, both before they give birth and afterward.
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HHS wants to require nursing homes to disclose more ownership and management information; privacy advocates warn that mental health data can legally be sold from certain platforms not covered by the Health Insurance Portability and Accountability Act; the FDA won’t review Soligenix’s cancer drug proposal because of an insufficient application.
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Pediatric Oral Health Services in Medicaid Managed Care and Fee for Service
Rates of preventive oral health services among pediatric medical visits in Florida were similar whether visits were paid via Medicaid comprehensive managed care or fee for service.
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CMS Releases Guidance on the Math Behind Part B, Part D Drug Rebates
February 10th 2023The Biden administration released 2 sets of guidance documents for pharmaceutical manufacturers about how it plans to implement the new Medicare Prescription Drug Inflation Rebate Program as required under the Inflation Reduction Act, and said some beneficiaries could see lower coinsurance for some Part B drugs as soon as April 1.
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