Health Care Delivery

Since 2005, American Cancer Society has sponsored the Health Insurance Assistance Service, a unique initiative to help cancer patients navigate the private coverage system and to educate policy makers about how coverage works for patients with this serious and chronic condition.

When it comes to health coverage, most Americans face an unnerving reality-they have no idea what is covered under their health insurance policy until after they are affected by illness or disease.

Questions about hospitals or their foundations paying for premiums of sick patients to keep them out of Medicaid are as old as the exchanges themselves.

What we're reading, August 19, 2016: CMS is investigating if patients are being steered away from Medicaid and Medicare to private plans; Medicare Part D paid 17% more for drugs in 2014 than in 2013; and 5 things to know about HIPAA today.

What we're reading, August 17, 2016: Walgreens looks to gamify medication adherence; Aetna warned the Department of Justice that if its merger wasn't approved, it would pull back from exchange participation; and the controversy behind numbers of medication error deaths.

Many accountable care organizations are beginning to adopt various programs or strategies into their framework to increase patient access to behavioral health care, but several challenges remain.

Another large insurer says it can't sustain losses from people who were sicker than anyone imagined. Leaving unprofitable markets doesn't answer the question of how to pay for their care.

What we're reading, August 16, 2016: hospitals are partnering with ride-hailing services to get patients to their appointments; Democrats look to repeal a ban on federal funding for abortion; and Colorado will vote on a right-to-die bill this fall.

This week, the top stories in managed care include news on how Medicaid expansion improved health outcomes of low-income individuals, a report on how physical activity lowers risk of 5 common chronic conditions, and findings on how insurance type impacts health outcomes in cancer.

What we're reading, August 12, 2016: CMS announces Obamacare plans saw a healthier mix of consumers last year; the number of babies born addicted to opioids tripled in 15 years; and the Obama administration will shift funding from HHS to fight Zika.

The future of Accountable Care Organizations is very much undefined, as an ACO right now isn’t working to its full potential. However, Joe Antos, PhD, the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American, is positive that the healthcare system will get there in the coming years.

Panelists Leah Binder; Austin Frakt, PhD; Margaret E. O'Kane, MHA; and Matt Salo discussed the Choosing Wisely campaign, patient engagement, the effects of the Affordable Care Act so far, and more.

What we're reading, August 11, 2016: hospitals are throwing out less-than-perfect organs and refusing transplants; why an increasing reliance on hospitalists is bad for comprehensive care; and removing the roadbloack to marijuana research.

While there is no limit on the number of patients a physician can prescribe buprenorphine when sought for pain, physicians face governmental limitations on prescribing this medication to patients who need it as treatment for opioid addiction, said Kelly J. Clark, MD, MBA, president elect of the American Society of Addiction Medicine. These restrictions have in turn created several patient access roadblocks to the needed medication.

What we're reading, August 10, 2016: mortality rate in the United States declines after 2015's increase; infant death in Texas linked to Zika virus; and Ohio colleges drop student health insurance due to Obamacare provisions.

Health insurance status can have a big impact on a person’s health outcomes after they are diagnosed with cancer, according to 2 new studies published in CANCER.

Medicaid expansion programs in Arkansas and Kentucky were found to be equally effective at improving healthcare access for the target population. Both programs face revisions following the election of Republican governors, who want to add work requirements.

Healthcare may not be the leading focus in the 2016 presidential race, but the candidates agree that there are issues that need to be addressed. This infographic breaks the difference between health policy proposals from Donald Trump and Hillary Clinton.

What we're reading, August 8, 2016: a new Medicare law would require hospitals to notify patients about loopholes in nursing home coverage; e-cigarette makers flooded the market ahead of new regulation implementation; and California bill on nurse-midwife independents causes controversy.

The 2016 presidential race has been mostly about the candidates' personal qualities and less about their policies. But that doesn't mean Donald Trump and Hillary Clinton don't have debate-worthy ideas in their healthcare platforms.

Panelists Leah Binder; Austin Frakt, PhD; Margaret E. O'Kane, MHA; and Matt Salo discussed Medicaid expansion, the medical loss ratio, managing specialty populations, and more during the Healthcare Reform Stakeholders Summit.

In an attempt to appease the Department of Justice and save their proposed merger, Aetna and Humana make deals to sell certain Medicare Advantage assets to Molina Healthcare.

What we're reading, August 4, 2016: a new startup is aiming to move clinical trial data to the cloud; Aetna is informing physicians about the opioid prescribing habits; and Florida deploys a mosquito control team to combat Zika virus.

Outpatient service charges are estimated to cause a 29.9% spike in healthcare premiums in 2017, much higher than the 14.3% projected for medications.

What we're reading, August 3, 2016: Medicare penalties for hospital readmissions reach a new high; the importance of down-ballot races this election; and Virginia's Bureau of Insurance comes out against the Anthem-Cigna merger.

What we're reading, August 2, 2016: co-ops in New Mexico and Massachusetts sue the government over the risk-adjustment formula and why hospital ratings should be viewed with a bit of skepticism.

Consumers on the Affordable Care Act's public exchanges have shown a willingness to shop around for coverage that heath plans can tap into.

What we're reading, August 1, 2016: proponents of Colorado's proposed state universal healthcare want Bernie Sanders' help; thousands need new health coverage in Ohio and Connecticut; and the trouble with getting a patient off a prescription.

The American Enterprise Institute released a report that detailed several proposals of change for the ACA that could possibly be implemented with the next president. Joe Antos, PhD, the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute, said that though these changes would depend on the party in office, implementing them wouldn’t necessarily be easy.