Laura Joszt, MA

An analysis of whole-genome sequencing (WGS) in healthy adults in the primary care setting found that 1 in 5 had a previously unrecognized variant associated with a rare disease, according to a study published in Annals of Internal Medicine.

From 2011 to 2014 the use of high-intensity statins following hospitalization for myocardial infarction (MI) increased progressively, according to a study published in Journal of the American College of Cardiology.

Whipple’s disease (WD) is a rare disease that predominantly affects middle-aged white men, and its diagnosis is often delayed because it is misdiagnosed as rheumatoid arthritis. A new study in Orphanet Journal of Rare Diseases aimed to describe clinical symptoms of WD and appropriate treatment.

On Thursday, the House of Representatives passed a bill that would reform medical malpractice by capping noneconomic damages at $250,000. Supporters say the reform would reduce frivolous claims and prevent doctors from practicing costly defensive medicine. Here’s a look at 5 aspects of medical malpractice in the United States.

With half a year behind us, The American Journal of Managed Care® (AJMC®) is reflecting back on the journal articles published through all journals in the franchise over the first half of 2017. The topics of interest ranged from alternative payment models to yoga and all focused on providing better care and better outcomes for patients.

With the year 2017 halfway over, The American Journal of Managed Care® is looking back at the news of the first half of the year. Here we bring you the most read news stories, including conference coverage, a take on the new president’s first executive order, reimbursement challenges, and more.

Republican leaders in the Senate unveiled a long-awaited healthcare reform bill, called the Better Care Reconciliation Act of 2017, that will roll back the Affordable Care Act’s taxes and Medicaid expansion, although at a slower timeline than included in the House of Representatives’ American Health Care Act, which was passed on May 4 by a vote of 217-213.

Coverage from the 2017 Spring Live Meeting of the ACO & Emerging Healthcare Delivery Coalition® on May 4-5, 2017, in Scottsdale, Arizona.

Although the country is moving toward value-based payments, for providers it’s basically still a fee-for-service world, said Charles J. Fazio, MD, MS, of HealthPartners Health Plan, at America’s Health Insurance Plans’ Institute & Expo, held June 9-10 in Austin, Texas.

AJMCtv® interviews let you catch up with experts on what’s new and important about changes in healthcare. The interviews provide insights from key decision makers-from the clinician to the health plan leader to the regulator. When every minute in your day matters, AJMCtv® interviews keep you informed. You can access the video clips at www.ajmc.com/interviews.

A new report from CMS has shown that nearly 2 million people who selected an Affordable Care Act health plan on the exchanges did not pay their insurance premium to maintain health coverage just 2 months later.

With the sustainability and affordability of the US healthcare system in dire straits, now is the time for collaboration on new payment models, explained chief executive officers from a health plan and an insurer during a general session on the second day of America’s Health Insurance Plans’ Institute & Expo, held June 7-9 in Austin, Texas.

The United States is only slightly halfway through its healthcare transformation, claimed Mike Leavitt, founder and partner of Leavitt Partners and the former governor of Utah, during a general session on the first day of America’s Health Insurance Plans Institute & Expo, held June 7-9, in Austin, Texas.

During a general session at America’s Health Insurance Plans’ Institute & Expo, held June 7-9 in Austin, Texas, Eric Topol, MD, explained the buzz behind precision medicine and why it is needed to combat the harms of imprecision in medicine.

Bacteria in the gut microbiome is associated with disease progression or delay in patients with metastatic melanoma who were treated with immunotherapy, according to a study presented at the 2017 American Society of Clinical Oncology Annual Meeting.

Healthcare costs for patients with Duchenne muscular dystrophy (DMD) are already far higher than for individuals without the disease, and a new study has found that total healthcare costs are also higher for older patients with DMD.

As Senate Republicans workshop their own healthcare reform bill, they are considering removing the tax exemption for employer-sponsored health insurance plans. Such a proposal would likely face stiff opposition. So what is the exemption and what would be the benefit of removing it?

While statins are primarily used to lower cholesterol, they are also associated with improved heart structure and function, according to research presented at EuroCMR 2017, which was held by the European Society of Cardiology, May 25-27, in Prague, Czech Republic.

Patients with cystic fibrosis face a lifetime of time-consuming treatment. There are new breakthrough therapies that not only treat symptoms of the disease, but also the underlying causes, which represents a source of hope for patients. However, barriers to treatment still stand in the way, according to a new white paper from the Cystic Fibrosis Engagement Network.

The National Heart, Lung, and Blood Institute has released the first-ever COPD National Action Plan, which is aimed at ending the illness.

Although providers might turn to PCSK9 inhibitors to treat patients at risk for atherosclerotic cardiovascular disease or familial hypercholesterolemia for whom statins do not work, the initial denial rate for this therapy can be very high.

A panel discussion on biosimilars at the ISPOR 22nd Annual International Meeting compared the progress in the United States with Europe, which has had a 10-year head start on the market.

Gene therapies have tremendous potential. They are a short treatment that could have lifelong effects. However, the very expensive therapies have a lot of unknowns and raise a number of ethical and practicality questions.

The notion of letting Medicare negotiate drug prices has been around for years, but has recently gained new traction under President Donald Trump. Panelists at the ISPOR 22nd Annual International Meeting, held May 20-24 in Boston, Massachusetts, discussed the complexities of allowing Medicare to negotiate prices and whether or not it would produce meaningful savings.

Is it possible to leverage social networks to influence response to treatment among an untreated population? During the second plenary at the ISPOR 22nd Annual International Meeting, held May 20-24 in Boston, Massachusetts, Nicholas Christakis, MD, PhD, of Yale University, described his research into social network interventions.

Of the payers who have an outcomes-based contract in place, only 9% view them as being very successful, while 50% say they are somewhat successful. Panelists agreed that flexibility is necessary for these contracts to succeed.

Stakeholders’ perspectives can vary, and their different preferences matter when it comes to value assessment, but only if the right questions are being asked.

Healthcare is a complicated issue with few, if any, easy fixes. The important thing is that the country continues to move forward, according to panelists during the first plenary at the ISPOR 22nd Annual International Meeting, held May 20-24 in Boston, Massachusetts.

Following a whistleblower’s assertion that UnitedHealth Group was inflating Medicare diagnoses in order to get more money from the Medicare program, the US Department of Justice has filed a lawsuit alleging the company knowingly inflated risk adjustment payments by making beneficiaries seem sicker than they were.

Medical financial burden has been highest for families in the nongroup market. After the implementation of the Affordable Care Act, the share of families experiencing financial burden declined 6.7 percentage points, Health Affairs study finds.