AJMC® in the Press, October 4, 2019

A study published in The American Journal of Managed Care^® (AJMC^®), “Influence of Out-of-Network Payment Standards on Insurer—Provider Bargaining: California’s Experience,” which examined the early effects of California’s policy addressing surprise medical billing, was cited by an article appearing in The Washington Post. The study concluded that out-of-network payment standards can influence the payer­—provider bargaining landscape, affecting network breadth and negotiated rates. The study was also highlighted by RevCycle Intelligence.

Health IT Analytics’ article on risk stratification referenced a study published in the October issue of AJMC^®, “A Deep Learning Model for Pediatric Patient Risk Stratification.” The study conducted a comparative predictive analysis of deep learning versus other popular risk prediction modeling strategies and found that the deep learning model outperforms traditional risk models in prospective hospitalization prediction.

An article from MedCity News included data from a piece in Evidence-Based Oncology™, a sister publication of AJMC^®. The piece, “Addressing Oncologists’ Gaps in the Use of Biosimilar Products,” reported findings from an effort to develop and deploy live and online expert-led, interactive, continuing medical education—certified activities to better prepare medical oncologists, hematologists, and other clinicians to incorporate biosimilars into the treatment paradigm for patients with cancer.

The Biologics Prescribers Collaborative’s Biologics & Biosimilars Bulletin included a handful of articles from AJMC^®’s sister site The Center for Biosimilars^®. The article “Bipartisan Bill Seeking to Curb Step Therapy Introduced in Senate” covered a bill introduced that would amend the Employee Retirement Income Security Act to require group health plans to provide an exemption process for step therapy, and the article “Global Coalition of Regulators Voices Confidence in Biosimilars” reported a statement from a coalition of regulators from 29 medicines regulatory authorities that expressed confidence in biosimilars.

The bulletin also included the article “FDA Releases Biosimilar Educational Materials for Patients,” which covered the agency’s release of a new suite of resources to educate patients about biosimilars; the article “FDA Releases Final Guidance to Determine if Citizen Petitions Are Abusive,” which covered the agency’s industry guidance intended to stop citizen petitions used by brand-name drug makers to delay the market entry of generics or biosimilars of branded products; and the article “2 More Bills Aiming to Boost Biosimilars Introduced in Congress,” which reported on 2 biosimilars bills that aim to boost uptake in the United States, one through increased Medicare payment and the other via additional education.

OBR Oncology also included an article from The Center for Biosimilars^® in its Wednesday newsfeed. The article, “Bipartisan ACCESS Act Would Eliminate Patient Co-payment for Biosimilars in Part B,” reported on newly introduced legislation that proposed to eliminate co-payments for patients when they receive a biosimilar rather than an originator biologic in Medicare Part B.