Health Care Delivery

Healthcare providers sometimes fail to consider the other aspects of a patient's life that could be affecting physical health and wellness, said Karin VanZant, executive director of Life Services at CareSource.

The update of the Urban Institute’s 2015 analysis suggests that the nation continues to be on track to spend much less on healthcare over the next several years than was projected by CMS in late 2010.

An initiative that provided Pennsylvania Medicaid patients with a primary care “medical home” reduced the costs of their care by up to $4100 per year and decreased the number of their physician visits and hospitalizations.

Sustainability in the Affordable Care Act marketplaces will occur when the health plans and the providers come together to establish both cost and quality goals and work together to achieve them, explained Karen Ignagni, president and CEO of EmblemHealth.

The most recent Kaiser Health Tracking Poll was conducted during an exceptionally violent week. Concerns about terrorism and gun policy outranked jobs and the economy and healthcare as voter priorities.

Faulty assumptions about the best ways to address the needs of minority patients may be lead to racial and ethnic disparities in the treatment of mental health and substance use disorders.

The top stories in managed care this week included coverage of JAMA’s special issue on healthcare transformation under the ACA, changes in the proposed 2017 Physician Fee Schedule promoting value-based care, and more.

What We’re Reading, July 15, 2016: What can the 7 remaining co-ops do to survive; CMS projects increased Medicare spending per enrollee by 2025; and experts call for policy changes to support the health of prisoners at high risk for HIV.

On the first day of the annual meeting of the American Society of Clinical Oncology, healthcare experts from the United States, Canada, and the United Kingdom, compared and contrasted the care models that are widely adopted in each nation.

What We’re Reading, July 14, 2016: Inaccurate provider directories in California health plans; atehnahealth survey identifies low physician engagement; and opioid addiction bill will soon be law.

While some insurers are questioning the sustainability of the Affordable Care Act health insurance markets, Erica Hutchins Coe, partner and co-leader of Center for US Health System Reform at McKinsey & Company, said that carriers continue to see new entrants on their exchanges, which she believes makes for a promising future.

Though the implementation of the Affordable Care Act has introduced various beneficial provisions for the American public, Joe Antos, PhD, the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute, said that he still sees room for improvement.

Subscribers migrated to Affordable Care Act—compliant plans with modestly higher costs, but had higher levels of insurance coverage and stronger consumer protections.

What We're Reading, July 12, 2016: Oregon's Health CO-OP to close down by the end of July; experts discuss fairer ways to decide on drug pricing; and gender bias in physician salaries at academic institutions.

The president predicts that in 20 years, the nation will look back on "Obamacare" as a moment of courage that has improved people's lives.

Jay Sheehy, senior vice president of product innovation at EmblemHealth, explained that being able to tailor your message to specific patient populations will help to better engage consumers, which will prove to be more successful for healthcare companies in the long term.

Hepatitis C is an enormously common disease that is often initially asymptomatic. New drugs are very effective, but expensive, and there has been reluctance to cover these treatments. Authors that published research in the hepatitis C special issue present their findings.

The number of individuals experiencing difficulty paying for healthcare or medicines has hit a record low since the implementation of the Affordable Care Act.

This week in managed care, the top stories included a report on how much Americans spend on complementary health approaches, more trouble with the Affordable Care Act's risk adjustment program, and researchers linked the BRCA1 gene to deadly uterine cancer.

Experts at a summit convened by the National Comprehensive Cancer Network (NCCN) agreed that progress in health information technology can help break the walls between compartmentalized data that lives within distinct data systems, to improve patient outcomes.

According to Kelly J. Clark, MD, MBA, president elect of the American Society of Addiction Medicine, payers and pharmacy benefit managers can aid in patient access to the medication they need to treat addictive disease by ensuring an evidence-based prior authorization protocol, just as they would for a patient with a chronic disease.

What we're reading, July 6, 2016: the Department of Veterans Affairs has made progress, but still has a long way to go; court upholds 6-month delay for biosimilars; and Apple promotes organ donation with iPhone app.

Connecticut Insurance Commissioner Katharine L. Wade moved to protect existing policyholders after HealthyCT learned June 30, 2016, it would have to pay CMS $13.4 million under the ACA Risk Adjustment program, which has been heavily criticized.

What we're reading, July 5, 2016: South Carolina's Obamacare health insurance exchange is close to collapse; hepatitis C virus treatment restrictions are being slowly lifted; and a special feature on what foods are healthy.

This week, the top stories in managed care include the largest healthcare fraud takedown, one successful accountable care organization imparted its secrets, and a report identifies pharmacy trends in the public health exchanges.

In the most recent Web-based session of The American Journal of Managed Care’s ACO & Emerging Healthcare Delivery Coalition, speakers examined 3 practice transformation models.

What we're reading, July 4, 2016: a hospital is offering free housing to get super-utilizers out of the emergency room; campaigns for patients to gain access to stem cell treatments are gaining momentum; and why hospital/physician integration and consolidation probably won't lower costs.

In the last 5 years urgent care has seen a rise in popularity. Here are 5 facts about urgent care clinics.

What we're reading, June 30, 2016: one doctor makes the case for the FDA moving away from a simple approval/no approval system; Massachusetts and Gilead come to an agreement over hepatitis C drug rebates; and Georgia considers Medicaid expansion.

Coverage from Patient-Centered Diabetes Care, April 7-8, 2016. Presented by The American Journal of Managed Care and Joslin Diabetes Center.