Brooke McCormick

Medicare Advantage (MA) plans, with fixed payments based on medical complexity, incentivize aggressive coding of comorbidities, potentially inflating costs for the federal government, according to Andrew S. Oseran, MD, MBA, MSc, of Beth Israel Deaconess Medical Center.

Of the surveyed physicians, 93% reported that prior authorization delays patient care, and 89% said it contributes to burnout.

These findings support the claim that Medicare Advantage (MA) payments may be driven more by diagnosis and coding practices rather than differences in disease burden between MA and fee-for-service (FFS) Medicare beneficiaries.

Higher telemedicine adoption among Medicare beneficiaries was associated with a slight increase in total visits but a reduction in certain low-value tests and related spending.

The rising frequency of natural disasters due to climate change could make health plans more susceptible to significant negative effects, according to Maria DeYoreo, PhD, of RAND Corporation.

Although her recent study acknowledges potential differences between White and non-White patients with psoriatic arthritis (PsA), Rebecca Haberman, MD, NYU Langone Health, emphasizes the need for further research to understand what these differences are and why they occur.

The study found no evidence that geographically limited disasters significantly reduced annual quality performance scores, highlighting the resilience of these programs.

President Donald J. Trump pushed for significant health care changes during his first month back in office, through executive orders affecting managed care, drug pricing, and clinical trial diversity guidance.

The comparable rates of remission pre- and post-pandemic suggest that COVID-19 did not negatively impact the outcomes of patients with ovarian cancer.

Recognizing psoriasis and psoriatic arthritis (PsA) in non-White patients is the first step toward providing more equitable care for those of all backgrounds with PsA, according to Rebecca Haberman, MD, of NYU Langone Health.

The study aimed to assess the effect of localized disasters on health plan quality performance scores, according to lead investigator Maria DeYoreo, PhD, of RAND Corporation.

In patients with early-stage ovarian cancer, a high prognostic nutritional index improved survival, while a high systemic immune-inflammation index worsened it. In advanced stages, both affected overall survival but not progression-free survival.

On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.

Although psoriatic arthritis may be more prevalent in White patients, Rebecca Haberman, MD, of NYU Langone Health, emphasizes that the disease affects those across diverse racial and ethnic backgrounds.

In this final interview clip, Michael A. Bernstein, MD, stresses the need for effective communication and proactive screening to contain the ongoing tuberculosis (TB) outbreak in Kansas City.

A positive association was found between osteoarthritis and overactive bladder (OAB), but rheumatoid arthritis and psoriatic arthritis were not significantly correlated with the condition.

In part 2 of this interview, Michael A. Bernstein, MD, highlights the need for prolonged antibiotics and strong public health measures to combat tuberculosis (TB) at both the individual and population levels.

The high prevalence of sarcopenia in patients with ovarian and endometrial cancers underscores the importance of early screening and preventive measures for these populations.

Michael A. Bernstein, MD, Stamford Health, addresses common misconceptions about tuberculosis amid the outbreak in Kansas City, Kansas.

In an interview with The American Journal of Managed Care, Michael A. Bernstein, MD, stressed the need for effective communication and proactive screening to curb the recent tuberculosis (TB) outbreak.

The number of psychiatrists submitting more than 10 claims to Medicare Part B decreased by 16.8% from 2014 to 2022.

These new data highlight the need for improved pain management among patients with cancer and survivors.

During the unwinding of continuous Medicaid provisions, 8.7% of pediatric patients at community-based health organizations became uninsured, with higher rates among older children, females, and those with chronic medical conditions.

A higher Dietary Inflammatory Index score was linked to an increased risk of hypertension in children and adolescents, emphasizing the role of diet in blood pressure regulation.

While genetic testing rates for advanced ovarian cancer have increased, gaps in physician understanding and confidence in interpreting results may limit optimal biomarker-driven treatment and patient access to genetic counseling.

Hispanic and non-White patients with psoriatic arthritis (PsA) had higher tender joint counts and greater disease severity, highlighting racial and ethnic disparities in PsA disease burden and treatment outcomes.

While all poly ADP-ribose polymerase (PARP) inhibitors improved progression-free survival, olaparib significantly extended overall survival (OS), making it a preferred option.

Private equity hospital acquisitions in the US were associated with declines in patient care experience, particularly in overall hospital ratings, willingness to recommend, and staff responsiveness.

Medicare Advantage enrollees, particularly Hispanic and Asian or Pacific Islander decedents, use less end-of-life home health care than those enrolled in traditional Medicare.

A genetic causal link between rheumatoid arthritis (RA) and an increased risk of traumatic and osteoporotic fractures underscores the need for targeted prevention strategies.