Getting CGM Covered by Medicare Still on the Agenda
January 2nd 2015Advocacy groups led by the JDRF gained strong bipartisan support for a bill in the last session of Congress, even though it was introduced late in the session. Those who support gaining Medicare coverage for devices that allow persons with type 1 diabetes to better monitor their blood sugar believe that bodes well for passage in the session that begins next week.
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Double-Digit Growth Projected in the US Telehealth Market by 2020
January 1st 2015The US patient monitoring market is projected to grow over $5 billion by 2020 driven by the demand for customized healthcare solutions, increased chronic illness amongst the aging population, and strained healthcare budgets.
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87% of HealthCare.gov Consumers Receiving Financial Assistance for Premiums
January 1st 2015A large majority of people who selected health insurance plans through HealthCare.gov during the first month of open enrollment for 2015 will receive financial assistance for their monthly premiums, according to HHS.
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Patients Overly Optimistic About the Benefits of Treatments, Tests, Screening
January 1st 2015Patients have a naïve optimism about medical care. A new study in JAMA found that patients have an unrealistic expectation of the benefits and harms of common medical treatments, tests, and screens.
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Two-Thirds of States Have Little Physician Quality Information Available
December 31st 2014Only a few states have readily available information on the quality of physician care, according to the second annual State Report Card on Transparency of Physician Quality Information from the Health Care Incentives Improvement Institute.
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So Far, 7.1 Million Have Used Exchanges to Get Health Coverage for 2015
December 31st 2014A report from HHS notes that through December 15, 2014, 52% of enrollees were new consumers, which could indicate that the Obama Administration is on track to meeting its goal of signing up 9 million Americans for health coverage on the exchanges in 2015.
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Material Need Insecurities Associated With Diabetes Control, Healthcare Utilization
December 31st 2014Simply increasing access to care is not enough to improve the health of patients with diabetes mellitus as a new study in JAMA has also associated the difficulty of paying for food and medications with poor diabetes control.
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AJAC Features Matt Salo on Medicaid After the Midterms
December 30th 2014Matt Salo, executive director of the National Association of Medicaid Directors, is emerging as one of the most important observers in how the expansion of the leading healthcare program for poor Americans is unfolding across the country. In December's issue of The American Journal of Accountable Care, he addresses how the fallout of the 2014 midterms will affect Medicaid in the near term.
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The Year in Review: Most-Read Stories of 2014
December 30th 2014With 2014 coming to a close, The American Journal of Managed Care is taking a look back at the most popular articles from this year. These most-read articles highlight the healthcare issues most important to providers, insurers, and policy makers.
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Accenture Wins Renewed Contract to Continue Work on HealthCare.gov
December 30th 2014After website glitches stole the spotlight during the first open enrollment period for the Affordable Care Act, CMS hired Accenture to fix HealthCare.gov. Now, the consulting firm has been awarded a 5-year, $563 million contract to continue working on the website.
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Health IT-Related Adverse Event Reporting Needs Improvement
December 30th 2014Improved and standardized reporting across healthcare organizations is needed to better understand the impact of health information technology (IT) on adverse events, according to a report from the Office of the National Coordinator for Health IT.
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In New Jersey, Medicaid Backlog Leaves Families Uninsured, Could Prompt ACA Penalties
December 30th 2014Several states hit backlogs enrolling the flood of new Medicaid recipients under the Affordable Care Act (ACA), but New Jersey's experience appears to be in a category of its own: an effort to upgrade antiquated computer systems and fold in the ACA at the same time failed miserably, leaving an estimated 11,000 residents without coverage as 2014 ends.
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Aetna Faces Class Action Lawsuit Over Mail-Order Requirement for HIV Drugs
December 29th 2014The plaintiff, John Doe, alleges that not having access to a community pharmacist will limit his ability to gain counseling on potential drug interactions. United Healthcare settled a similar action earlier in 2014. Consumer groups have also alleged discrimination against HIV patients by insurers over drug access in Florida.
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States Focus on "Super-Utilizers" to Reduce Medicaid Costs
December 28th 2014Using a provision of the Affordable Care Act, many state Medicaid agencies are trying to diminish use of medical services by super-utilizers by better managing their care. The goal is to not only reduce costs, but to achieve better health outcomes for these patients.
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Gardasil 9 Approved for 5 Additional HPV Types
December 27th 2014With this approval, the vaccine can effectively protect against 5 additional types of HPV than the parent Gardasil vaccine, thereby preventing the development of cervical, vulvar and vaginal cancers, based on a randomized clinical trial.
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Health Insurers Provide Additional Flexibility for Premium Payments
December 27th 2014To provide a smooth transition in the first year of the auto-enrollment and renewal process, health plans are voluntarily providing flexibility with payment deadlines for consumers purchasing coverage through the federal Marketplace.
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Immuno-Oncology Getting Closer to Being Personalized: Nature Study
December 27th 2014The Nature letter published results showing that the monoclonal antibody targeting PD-1 had antitumor activity, but more importantly, the response was greater in patients overexpressing the PD-L1 receptor, thereby opening the doors for targeted therapy.
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As Louisiana's Jindal Contemplates 2016 Run, CMS Delivers Back-to-Back Blows
December 26th 2014Republican Governor Bobby Jindal moved quickly to privatize 6 public hospitals with advanced lease payments, and he set up a prescription reimbursement schedule without prior approval from CMS. The agency signed off on privatization but rejected both financial pieces this week, which could leave Louisiana's next governor with a budget shortfall.
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Medicare's Measure for Readmissions Fails to Identify Excellence and Improvement
December 25th 2014San Diego County is doing much better than the national average at reducing readmissions to hospitals, yet nearly all their eligible hospitals are being penalized by Medicare's hospital readmissions penalty program.
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