Policy

Expansion or not, it is obvious that states must consider how to make their Medicaid programs more sustainable.

Most Americans don't want the government to decide if medical treatments are economical before letting patients use them, a new survey suggests.

In the past few years, efforts to lower costs and improve care have proliferated.

Clinical trials and treatment in multiple sclerosis (MS) place an unwelcome economic burden upon countries with MS prevalence. With rising costs and a growing interest in MS clinical trials from emerging countries, new studies are needed to evaluate the significance of these factors.

Melanie Bella, director, Medicare-Medicaid Coordination Office, Centers for Medicare & Medicaid Services, says the sole focus of the Medicare-Medicaid Coordination Office is to increase coordination and access to services from many fronts.

The Obama administration on Wednesday released a long-awaited report on premiums in Obamacare's federal insurance exchanges - the first look at the rates that will apply in the vast majority of states.

Jan Berger, MD, MJ, president & CEO, Health Intelligence Partners, and editor-in-chief of The American Journal of Pharmacy Benefits, says that historically medication adherence, when it pertained to PBMs, was really just about selling pills-it was an isolated, siloed issue.

It is up to physicians to seek education and training on genetics. Panelists agree that it is important for patients to speak with a genetic counselor even if it is over the phone.

MedPAC, the Congressional advisory committee on Medicare, discussed how to get patients more involved in their health decisions.

Health Information Technology (HIT) is expected to make patients' medical information not only more accessible, but easier to share among providers. Yet, despite the promising capabilities of HIT, providers are not entirely convinced about the costs that come with health technology.

A new study suggests that primary care providers participating in an accountable care organization (ACO) and having greater engagement with patients transparency into the cost of services and procedures have the ability to bend the healthcare cost curve by an 8 to 1 margin in terms of return on investment (ROI).

Panelists all agree that there needs to be evidence and guidelines for both payers and providers. There are not enough resources to try every drug on every patient. Although it will be costly, there needs to be evidence on putting these drugs together as combinations.

Two new studies have put a price tag on healthcare services considered of little benefit to patients. In both reports, researchers raised questions about the role that healthcare providers play in delivering potentially unnecessary care.

Hospitals and healthcare systems nationwide are increasingly buying more physician practices as health reform requires care delivery to move toward a more quality-based care model instead of a fee-for-service one. The reactions are mixed.

Bargaining leverage, not the cost of providing complex care, is the main reason why some hospitals can demand prices twice as high as their competitors' and still get contracts to treat privately insured patients, according to a new study.

A study estimates that total annual costs for five major health care-associated infections (HAIs) were $9.8 billion, with surgical site infections contributing the most to overall costs, according to a report.

Premium rates for health plan policies in the health insurance exchange (HIE) are expected to vary nationally, but they aren't likely to skyrocket - at least according to one research group.

Accountable care organizations (ACOs) and other coordinated care models present opportunities for improving quality as well as offering incentives that will drive lower-cost decision making among providers

As healthcare costs rise in Florida, insurers and hospitals vested in the success of the Affordable Care Act, are coming up with new ways to cut costs from buying services in bulk and piloting programs to lowering hospital readmission rates and limiting the number of doctors within a plan's network.

The nation as a whole is facing a physician shortage. The Association of American Medical Colleges estimates that the United States will have a shortfall of 90,000 physicians within the next decade.

The most important piece of legislation in Michigan, and perhaps the country, remains idle on the floor of the Michigan Senate.

While the employer mandate delay and other stalls in the implementation of the Affordable Care Act have raised a few eyebrows, a recent report from the Kaiser Family Foundation brings forth some encouraging news.

Opinions rage about whether health insurance costs will rise or fall with implementation of the Affordable Care Act, commonly known as Obamacare.

Health services are now expected to deliver quality care with a shrinking budget. The digital 'channel shift' could be the answer, but attitudes to technology in the sector must change.

David Lansky, PhD, President & CEO, Pacific Business Group on Health, says that Accountable Care Organizations (ACOs) must truly be accountable for the care they provide.

Roger B. Fillingim, PhD, president of the American Pain Society is one advocate speaking out about the problem faced by patients who suffer from chronic pain, defined as being present for 3-months or more. But he's not the only expert who is talking about finding better ways to help people in pain.

Shelley Toreson had health insurance for years, but not anymore. Instead, she is part of an unusual Nevada nonprofit that helps connect 12,000 uninsured residents to doctors and hospitals who are willing to accept a lower-cost, negotiated fee for their services.

Mr. Shopenn, 67, an architectural photographer and avid snowboarder, had been in such pain from arthritis that he could not stand long enough to make coffee, let alone work. He had health insurance, but it would not cover a joint replacement because his degenerative disease was related to an old sports injury, thus considered a pre-existing condition.

Delaying the employer insurance mandate until 2015 has cost the government an estimated $12 billion in fees. This coming after an assessment conducted by The Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) on the impact the delay will have on the Affordable Care Act (ACA) implementation.

It was the late C. Everett Koop, a former U.S. surgeon general, who once famously said: Drugs don't work in patients who don't take them. That's a simple way to look at a costly and complex problem - medication non-adherence - where the failure to take drugs on time in the dosages prescribed is both dangerous for patients and costly to the health care system.