Policy

Use of a specialty pharmacy to take over the management of prior authorization (PA) requests for a dermatology practice significantly reduced the time to a decision and also decreased the time it took to fill the medication.

On this edition of Managed Care Cast, we present a short excerpt from a January webinar titled “Color and COVID-19: The Virus’ Disproportionate Impact” hosted by the MJH Life Sciences™ COVID-19 Coalition about how the pandemic has had an unequal, devastating impact on communities of color.

A German-style fair value/pricing committee may be in the works for the United States. However, government payers still have work to do before implementing a value assessment system.

As Medicaid is a federated program between states and the federal government, it has historically been difficult for innovation to spread state to state, hindering any comparison of quality metrics.

The coronavirus disease 2019 (COVID-19) pandemic has led to sharp declines in US life expectancy; a new CMS administrator nominee is selected; Biden administration announces funds to combat virus variants.

Former HHS secretary Kathleen Sebelius and Sachin Jain, MD, MBA, CEO of SCAN Group and Health Plan, took time to reflect on the advent of the Affordable Care Act (ACA) and examine the Biden administration’s opportunity to enact influential health policy on the first day of the 2021 AcademyHealth National Health Policy Conference.

Kicking off the 2021 AcademyHealth National Health Policy Conference, Marcella Nunez-Smith, MD, MHS, stressed the important role that accurate data play in the effort to prioritize health equity during the coronavirus disease 2019 pandemic.

Treatment of asthma with biologics was lower for those on public health insurance compared with those who had private insurance, with Blacks underrepresented relative to Whites in publicly insured visits where biologic treatment is used.

There is an urgent need to accelerate vaccination distribution for vulnerable Americans by overcoming problems involving social determinants of health.

The Biden administration purchases an additional 200 million coronavirus disease 2019 (COVID-19) vaccine doses; the president plans to revoke Medicaid work requirements; companies seek billion-dollar tax deductions in opioid crisis settlement.

Under Affordable Care Act Medicaid expansion in New Jersey, new and distinct patterns of primary care utilization emerged for new vs established enrollees.

The Department of Justice (DOJ), under a new administration, on Wednesday dropped its previous position that the now-defunct tax provision in the Affordable Care Act (ACA) cannot be severed from the rest of the law, thus making the entire health law unconstitutional.

Compared with pollen season in 1990, today's pollen season is starting earlier and lasting longer, largely because of human-caused climate change, researchers said.

Experts outlined the impact value-based insurance design (VBID) has had on the coronavirus disease 2019 (COVID-19) pandemic response and future potential applications of the model.

Medicaid managed care has not been the panacea for spending, care quality, and access that policy makers expected, but reforms could change that.

Patients’ socioeconomic status is a significant factor in predicting survival rates for multiple myeloma, according to a new study.

The FDA is scheduled to hear Johnson and Johnson's request for an emergency use authorization (EUA) for their coronavirus disease 2019 (COVID-19) vaccine later this month; Senate passes economic relief package; heavy metals found in some baby food.

With New York being at the crossroads of the HIV epidemic and the coronavirus disease 2019 (COVID-19) pandemic, a group of researchers wanted to know what, if any, correlation there was between the 2 disease states.

There needs to be broad acceptance of the role systemic racism plays in social determinants of health in order to improve metabolic outcomes among minority populations in the United States.

Johnson & Johnson, Novavax, release positive results from phase 3 trials on their respective coronavirus disease 2019 (COVID-19) vaccines; report indicates undercounted nursing home deaths in New York; experts push for improved mask practices.

The intersection of climate change and negative impacts on health were brought into sharp focus this week with executive orders from President Biden, a move by General Motors (GM) to stop making some gasoline-powered cars, and top global cardiology organizations calling for urgent action on air pollution.

The Biden administration will reopen the health exchanges created by the Affordable Care Act (ACA); direct HHS and other agencies to reexamine other health policies, including Medicaid work requirements; and reverse the so-called global gag rule while affirming support for reproductive health.

On this episode, we speak with the coauthor of a paper looking at the mental health stressors facing first responders and health care workers during the coronavirus disease 2019 (COVID-19) pandemic. The paper found that a sizable number of these frontline workers are at risk for psychiatric illnesses at severity levels higher than other national disasters, including 9/11 and Hurricane Katrina.

States with the most restrictive scope-of-practice laws have an inadequate supply of primary care clinicians to serve a high concentration of dual-eligible beneficiaries.

The FDA approved the first injectable monthly treatment for HIV; Eli Lilly announced positive effects of its monoclonal antibody treatment for coronavirus disease 2019 (COVID-19); President Joe Biden will sign an executive order on food insecurity.

President Joe Biden issued executive orders to speed up testing and vaccine distribution, and to require masks on planes, trains, and buses.

Nephrologist Mary Dittrich, MD, the chief medical officer and executive vice president of U.S. Renal Care as well as cofounder and partner of Boise Kidney & Hypertension Institute, discusses how to keep patients safe while providing high-quality kidney care during the coronavirus disease 2019 pandemic.

As the nation crossed the threshold of 400,000 deaths from the pandemic, the Biden transition team said that one of his first actions will be an executive order calling on Americans to do “their patriotic duty” and wear a mask.

Donald M. Berwick, MD, MPP, president emeritus and senior fellow at the Institute for Healthcare Improvement and former CMS administrator, discusses challenges in cancer care and health care awaiting the Biden transition team.

The authors of a Clinical research article in the January 2021 Health IT issue of The American Journal of Managed Care® discuss their findings and suggestions for making telehealth access more equitable for all.