Health Care Delivery

A dive into the Quality Payment Program and other healthcare reform models introduced in cancer care that healthcare providers are adjusting to as we move toward value-based care.

By identifying ways to improve cancer care and then designing alternative payment models (APMs) to overcome current payment barriers, APMs can enable oncology practices to deliver better care to patients and save money for payers in a way that is financially sustainable for the practices.

The steps taken at CMS seek to curb adverse selection, when consumers wait until they have a health problem to sign up for coverage, then cancel after they receive treatment.

Several polls released this week show that Americans’ opinions of the Affordable Care Act (ACA) are steadily becoming more positive, as approval of the law has topped 50% for the first time amidst unsuccessful efforts to repeal and replace it.

A poll conducted by PatientsLikeMe shows that cancer patients have the same concerns as the general population about healthcare costs, but see benefits in the law that the healthy may have overlooked.

Panelists, during a session on value and value-based reimbursement at the Academy of Managed Care Pharmacy Annual Meeting, held March 27-30 in Denver, Colorado, discussed the benefits and challenges of value-based contracting and the current and evolving use of value frameworks.

Have retail clinics changed the structure of our health system? Have they changed the way players in the system compete or interact with each other?

New targeted therapies reduce waste and identify patients that will benefit most, but their high price tags have left the healthcare industry scrambling to figure out how to pay for these treatments and cures.

The Academy of Managed Care Pharmacy Annual Meeting kicked off on March 28, 2017, in Denver, Colorado, with a look at the specialty pharmaceutical pipeline with Aimee Tharaldson, PharmD, senior clinical consultant for emerging therapeutics at Express Scripts.

Healthcare consulting is a growing industry touching each of the stakeholders involved in healthcare, and these consultants are playing an increasingly significant role in the United States healthcare system.

This supplement showcases the winning papers and case studies from the PAN Challenge, which aimed to stimulate a dialogue on ways to reduce or eliminate the barriers and disparities that Medicare and ACA enrollees face in obtaining medications to treat life-threatening, chronic, and rare diseases.

How peer-to-peer, community support programs can educate and empower patients to become more adherent to treatments, which will improve outcomes and reduce healthcare costs.

Questions about cost-sharing subsidies, risk corridors, and what to do about red state Medicaid expansion will confront the Trump administration no matter how much the president wants to move on to other issues.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

After weeks of negotiations and last-minute drama, the House GOP has pulled its Obamacare replacement bill after it became clear that there were not enough votes to pass it.

This week, the top stories in managed care included last-minute changes to Republicans' bill to repeal the Affordable Care Act; a lack of votes to pass the GOP health bill; and promising study results on PCSK9 inhibitors and SGLT2 inhibitors.

Debate on the House floor covered familiar ground: Republicans called for an end to the individual mandate and decried rising premiums and fewer insurers on the exchanges, while Democrats blasted the proposed cuts to Medicaid. The late change to cut essential health benefits cost House leaders a key moderate vote.

As House Speaker Paul Ryan, R-Wisconsin, and President Donald Trump endeavored to round up enough Republican votes to pass the American Health Care Act this week, a major sticking point for some reluctant GOP legislators was the inclusion of the Affordable Care Act’s essential health benefits in the replacement bill. Reports indicate that the essential health benefits requirement will be cut from the bill that will go to the House for a vote today.

House leaders and White House negotiators are unable to break the impasse created by conservatives, who say the bill does not sufficiently unravel Obamacare, and moderates who worry about lack of coverage for constituents.

At the 22nd Annual Conference of the National Comprehensive Cancer Network, held March 23-25, 2017, in Orlando, FL, policy researchers with interest in cancer care disparities discussed the source of existing disparities and how they can be successfully addressed.

House leaders are balancing the need to win votes from conservative members with the need to not put moderate members at risk.