Transition to Managed Care Proves Rough for Ohio Dual Eligibles, Reports Say
October 13th 2014Ohio is the latest state to experience a rough transition to managed care in its Medicaid program, according to weekend reports. Delayed payments and service disruptions to fragile patients are among the complaints. Kentucky had a similar bumpy start when it changed to Medicaid managed care in 2011, and Kansas has had many problems recently.
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Gilead's Harvoni Less Expensive, but Still a Burden on State Medicaid Programs
October 13th 2014Gilead Sciences' Harvoni represents the first once-a-day, complete treatment pill approved by the FDA to treat the hepatitis C virus (HCV). And for some patients, the drug will be less expensive than Gilead's other HCV treatment, Sovaldi.
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BMS' PD-1 Inhibitor, Nivolumab, to be Evaluated With Jansenn's Ibrutinib in NHL
October 13th 2014Opdivo (nivolumab), which was approved in Japan in July 2014, is being globally developed for evaluation in non-small cell lung cancer (NSCLC), melanoma, renal cell carcinoma (RCC), head and neck cancer, glioblastoma, as well as NHL.
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Reference Pricing Programs Yield Only Modest Savings
October 12th 2014Reference pricing programs can steer patients to lower-price, adequate quality providers, but potential savings to health plans and purchasers are actually modest, according to a study from the National Institute for Health Care Reform.
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Insurers Lose $73M in Kansas in 6 Months Thanks to Medicaid
October 12th 2014Medicaid expansion under the Affordable Care Act has been an overall success for insurers in most states that have implemented it; however, the story is different in Kansas, which switched its entire Medicaid program to a private model.
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ONC Report Acknowledges Interoperability Struggles, Barriers
October 11th 2014Despite progress being made, health information technology interoperability remains a struggle, according to a report submitted by the Office of the National Coordinator for Health Information Technology and HHS to Congress.
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Price Tags On Healthcare? Only In Massachusetts
October 11th 2014Without much fanfare, Massachusetts launched a new era of healthcare shopping last week. Anyone with private health insurance in the state can now go to his or her health insurer's website and find the price of everything from an office visit to an MRI to a Cesarean section. For the first time, healthcare prices are public.
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Less Imaging in Cardiac Stress Tests Could Add up to Managed Care Win, Study Finds
October 10th 2014A study conducted at NYU Langone Medical Center finds that unnecessary radiation in cardiac stress tests costs $500 million a year and causes nearly 500 cases of cancer. Greater use of ultrasound or treadmill tests could save money and improve patient safety; however, earlier studies by The American Journal of Managed Care point out possible barriers to these options.
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Preparing for 10 Trends That Will Impact Managed Care Pharmacy
October 10th 2014There are 10 emerging healthcare trends that will impact managed care pharmacy organizations over the next 5 years as the United States healthcare system places more emphasis on affordability, population health, and patient satisfaction and quality of care, according to a new report from the Academy of Managed Care Pharmacy.
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Low-Income Adults View Medicaid as Comparable to Private Insurance
October 9th 2014The majority of low-income adults in 3 states favored Medicaid expansion, but knowledge about their states' plans for the program under the Affordable Care Act was low, according to a report from the Commonwealth Fund.
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Near-Term Pressures Will Hold Healthcare Spending in Check, According to NEJM
October 9th 2014Even though roughly 9 million Americans have gained healthcare coverage, other forces related to the "anemic recovery" will keep healthcare spending under control, at least in the short term, writes Charles Roehrig, PhD, in a commentary published online yesterday in the New England Journal of Medicine.
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Genentech Faces Backlash Following Onco-Specialty Decision
October 8th 2014Having decided to restrict the distribution of 3 of its top-selling oncology medications, Avastin, Rituxan, and Herceptin only through specialty pharmacies, Genentech is witnessing protests in various forms from healthcare centers.
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Financial Results Reveal Why ACOs Left Pioneer Program
October 8th 2014CMS released financial results from the first 2 years of the Pioneer ACO program. The program is down to 19 accountable care organizations from the original 32 that started the program, and the financial results reveal why those that dropped out did so.
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Growing Expectations for Interoperability and Healthcare Data Sharing
October 8th 2014Over the last decade, all 5 national coordinators for health information technology have discussed the importance of connecting healthcare data, but the timing is finally right now, according to Karen B. DeSalvo, MD.
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Turning Big Data into Actionable Wisdom
October 8th 2014Although people seem to assume Big Data will answer all questions and improve quality of care while increasing efficiencies, the healthcare industry needs to focus on what data is actually actionable, according to John Halamka, MD, chief information officer at Beth Israel Deaconess.
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Amid Good News, CDC Data Show Uptick in Deaths From Suicide
October 8th 2014Amid yesterday's good news from the CDC that Americans are living longer than ever was a sobering fact. Rates for the top 10 causes of death all fell from 2011 to 2012, save one: suicide. The death rate increased from 12.3 to 12.6 deaths per 100,000 people.
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Nursing Home, Home Health Quality Measures to Undergo Overhaul, With More Disclosure for Consumers
October 7th 2014Payroll audits to ensure proper staffing and better tracking of the use of antipsychotic medications are just 2 new items that the Centers for Medicare and Medicaid (CMS) will add to its list of quality measures for nursing homes starting in January, the agency that oversees all Medicare spending announced Monday. The changes are due to passage of the Improving Medicare Post-Acute Care Transformation Act (IMPACT) which President Obama signed Monday. Some of the changes will bring managed care concepts to the home health sector, where regulations have not been updated in 25 years
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Results of a large study performed across cancer centers in Germany, published online October 6, 2014 in the Journal of Clinical Oncology, show that 32% of people with cancer experienced some form of clinically relevant mental health challenge, such as anxiety, depressive and adjustment disorders.
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