Policy

To help close health equity gaps, CMS finalized a rule that will update payment rates and improve incentives for providers to encourage them to increase access to home dialysis and kidney transplants for low-income patients with end-stage renal disease.

On this episode of Managed Care Cast, we speak with one of the coauthors of a study that illustrates the changing outpatient trends in a primary care provider’s (PCP) panel of Medicare patients and how that translates to an increased workload for primary care doctors.

The annual report, from the American Cancer Society, National Cancer Institute, the CDC, and the North American Association of Central Cancer Registries, details US cancer trends.

In the years since its inception, debates around the 340B program have centered on whether savings actually benefit the underserved as intended. A new paper in The American Journal of Managed Care® analyzed secondary data on 340B participation and uncompensated care provision from general acute care and critical access hospitals between 2003 and 2015.

Physician and health policy advocates praised the emphasis on streamlining models and ending silos, but practices that invested in the Oncology Care Model (OCM) await key details.

The Biden administration moves to regulate certain toxic chemicals; the FDA is expected to endorse mixing and matching vaccine boosters; nurse shortages could lead to care rationing in New Mexico.

Nicole Herbst, MD, a pulmonary and critical care fellow, talks about how visitor restrictions and communication practices in intensive care units (ICUs) during the COVID-19 pandemic negatively impacted provider job satisfaction and were linked to job burnout, according to a survey presented at the CHEST Annual Meeting 2021.

Researchers at the CHEST Annual Meeting 2021 addressed the evolution of COVID-19 variants, how these emerging strains impact vaccines, and preventive recommendations for at-risk populations.

Medicare Advantage enrollees, particularly those with lower out-of-network benefits, may have restricted access to top-ranked hospitals for complex cancer care compared with traditional Medicare enrollees.

Evan L. Stepp, MD, FCCP, CPE, a pulmonologist at National Jewish Health, director of the Highlands Ranch Clinic, and an assistant professor, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, discussed the recent FDA decision to authorize an e-cigarette intended to help current smokers quit combustible cigarettes.

An independent FDA advisory panel endorses Moderna boosters for select groups; circuit court lets Texas abortion law stand, paving the way for appeals; Robert Califf, MD, is reportedly being eyed to head the FDA again.

Participation in the 340B Drug Pricing Program by general acute care hospitals and critical access hospitals has not been associated with increased provision of uncompensated care.

The 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.

Pfizer and BioNTech ask FDA to authorize their COVID-19 vaccine in children; the World Health Organization (WHO) recommended widespread use of the world’s first malaria vaccine; a US judge blocks Texas’ strict abortion law.

Although 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.

On 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.

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.

Coverage of our peer-reviewed research and news reporting in the health care and mainstream press.

Long-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.

President Joe Biden reportedly will increase global COVID-19 vaccine donations; the pandemic may have led to an increase in home births; use of Biogen’s Adulhelm, an Alzheimer disease drug, does not hit initial projections.

An 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.

Pfizer says a newly formulated dose of its vaccine is safe and effective in children; CDC data underscore the efficacy of the 3 COVID-19 vaccines; Biden aims to reform health care with trillion-dollar package.

Considering the personal, societal, and economic toll of treatment-resistant depression, we must make it easier to access medicines and care that provide value, both for the patient and for the health care system.

A 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.

The 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.

Looking 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.

The 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.

COVID-19 hospitalizations among the unvaccinated cost billions between June and August; the Department of Justice called for a temporary block on the Texas abortion law; legislators limited the power of public health officials in at least 26 states, a report shows.

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.

Findings 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.