Health Care Delivery

A noninvasive colorectal cancer screening test manufactured by Exact Sciences, which received CMS coverage within months of its FDA approval, is not included under Humana’s coverage policy

Looking at trends in economic growth, healthcare costs, and employment, researchers find that the Affordable Care Act has acted as an economic stimulus.

What we're reading, February 15, 2016: despite cuts to the program, enrollment in Medicare Advantage is up 50% over 5 years; orphan drug designations from the FDA up 22% in 2015; and Zika virus infections on the rise in Puerto Rico.

Justice Antonin Scalia has died at the age of 79. The absence of the conservative justice from the Supreme Court bench has set off a political firestorm and could have repercussions for upcoming healthcare cases.

In spite of the Affordable Care Act's contraceptive coverage guarantee, there have been some obstacles in ensuring that privately insured women do not encounter out-of-pocket cost.

A study published in Cancer Epidemiology, Biomarkers & Prevention has identified geographic and ethnic factors as an important determinant of vaccinating against the human papillomavirus.

Every year, health policy wonks get into the loving spirit of Valentine’s Day with poetry, puns, and more on Twitter using the popular hashtag #HealthPolicyValentines. We round up some of the best.

Patients with advanced kidney cancer in the UK now have access to nivolumab through an early access scheme.

What we're reading, February 12, 2016: the former Kentucky governor is looking to block the current governor's plans to dismantle Kynect; Senator Orrin Hatch speaks out against Medicare negotiation of drug prices; and the link between Zika and microcephaly is growing stronger.

While the number and diversity of immunologically-based anticancer agents have increased dramatically, a number of challenging questions persist: sequencing with existing regimens, selection of best responders, cost, and patient access.

Although the United States is often viewed as having some of the best healthcare in the world, the validity of this assertion has been called into question for a number of years.

Seven of the states with the largest reductions in uninsured rates since the implementation of the Affordable Care Act have both expanded Medicaid and established a state-based exchange or a state-federal partnership.

A lack of diversity among healthcare providers can adverse effects for the communities they serve, explained Georges Benjamin, MD, executive director of the American Public Health Association.

An overview of patient assistance programs at Smilow Cancer Hospital at Yale-New Haven, including their innovative hospital-based explanation of benefits form, which can eliminate patient responsibilities and help expedite the turnaround times for payment processing with copay assistance.

The cost issues with immuno-oncology agents are real, but so is the value that they bring to the table. How can we improve access to these agents at a reasonable cost?

Innovation has remained high on the administration’s agenda, as is evident from the allocations to tackle climate changes as well as find treatments for devastating health conditions.

Julia Adler-Milstein, PhD, explains the importance of technology as a supporting factor in healthcare delivery, saying that it will enable patients to access their data and become more involved in their healthcare.

A. Mark Fendrick, MD, co-editor-in-chief of The American Journal of Managed Care and director of the University of Michigan Center for Value-Based Insurance Design, testified before a Michigan senate subcommittee on the benefit of clinical nuance.

What we're reading, February 9, 2016: Novartis signs 2 performance-based deals for its new heart drug; 8 states significantly reduced uninsured rates; and the Obama administration will ask for $1.8 billion to prepare to fight the Zika virus.

Ensuring rapid, appropriate, and sustainable access to immuno-oncology therapies for patients in Europe: what role can policies play?

The latest Kaiser Family Foundation tracking survey of registered voters finds the ACA is only one of many issues considered in the choice of who they vote for.

Many key guidelines regarding Medicaid and CHIP eligibility, enrollment, renewal, and cost-sharing policies have changed and the 14th annual 50-state survey from the Kaiser Family Foundation identified all the major changes that occurred in 2015.

What we're reading, February 8, 2016: 12.7 million people signed up for Affordable Care Act coverage, but 30 million remain uninsured; HHS plans to continue to encourage Medicaid expansion; and report analyzes the effect of patient-centered medical homes on cost and quality.

To address the nationwide concern of costly immunotherapy agents, this article features health system inpatient and outpatient strategies that can help mitigate their costs.

For HIV-positive patients, cost considerations take on added importance because of the expensive antiretroviral prescription medications. As such, assessing premiums alone may not provide an accurate measure of plan affordability for HIV-positive patients.

The top stories in managed care this week included increased insurer concerns over the sustainability of the Affordable Care Act's insurance exchanges, healthy policy experts convened in DC, and 2 warnings for women to heed regarding pregnancy.

The healthcare industry is undergoing payment reform, which includes important initiatives like addressing social determinants of health, but may not be keeping the patient perspective central as these changes are made, Lewis Sandy, MD, senior vice president of Clinical Advancement at UnitedHealth Group, said at the AcademyHealth National Health Policy Conference.

Supporting, funding, and protecting the research and development of new medicines and new treatments is more critical, now than ever, to provide better treatments and better outcomes to all cancer patients.

What we're reading, February 4, 2016: President Obama is proposing changes to the widely disliked Cadillac tax; Florida declares a health emergency in 4 counties over Zika virus; and drug makers are pouring money into efforts to improve medication adherence.

On World Cancer Day, The American Journal of Managed Care would like to acknowledge the determination of cancer survivors and the support provided by various organizations to patients and their families.