Health Care Delivery

CMS has announced proposed changes to the 2017 health insurance marketplaces aimed at providing choice and competition for consumers and improvements in consumer experience.

The future of patient engagement in healthcare will be mobile, which should also help reduce healthcare disparities as more and more less-fortunate groups adopt smartphones, said Joseph C. Kvedar, MD, vice president of Connected Health at Partners HealthCare.

While the 340B Drug Pricing Program was designed to help facilities that take care of impoverished patients with low-cost drugs, what the program has morphed into is almost the opposite of what it was intended to do, said Peter Bach, MD, MPP, director of Memorial Sloan Kettering's Center for Health Policy and Outcomes.

The HHS Pharmaceutical Forum brought together a diverse set of stakeholders to share ideas on delivering affordable but high-quality care, improving outcomes, and continuing to lead in innovation. Here are 5 things that came out of the daylong meeting.

At the Patient-Centered Oncology Care 2015 meeting, held November 19-20, 2015, in Baltimore, Maryland, keynote speaker Julie M. Vose, MD, MBA, FASCO, president of the American Society of Clinical Oncology provided perspectives on the challenges faced by oncologists as the healthcare system transitions to define and incorporate value in the care delivered.

Rates of uninsured individuals vary dramatically across the country, and while some states made huge gains in covered individuals, others have lagged behind.

Due to poor performance in the Affordable Care Act's health insurance exchange's, UnitedHealth Group is considered pulling its plans from the exchanges in 2017.

Eligibility for prescription coverage and family income significantly influenced women's decisions to continue hormonal therapy and prevent recurrence of breast cancer, the authors found.

What we're reading, November 19, 2015: the American Medical Association is calling for a ban on direct-to-consumer television advertisement of prescription drugs and popular silver plans on HealthCare.gov have largest premium increases.

The American Society of Clinical Oncology has made public its detailed guidance to CMS, supporting implementation of physician-focused and other alternative payment models under MACRA.

CMS has made available $32 million in funds to support efforts to further reduce the rate of uninsured children who are eligible for Medicaid or the Children's Health Insurance Program.

Many nonprofit hospitals have "far from perfect" performance on a requirement of the Affordable Care Act to notify patients who qualify for charity care.

The study suggests treating depression could help combating poor diet and obesity. But in Kentucky, the future of Medicaid expansion is in doubt following the recent election.

What we're reading, November 16, 2015: consumers face sticker shock on Affordable Care Act plans when they get sick and face high deductibles; Medicare spending on hepatitis C drugs nearly doubled in 2015; and US maternal mortality has worsened since 1990.

The Medicare Shared Savings Program is the perfect way for primary care physicians to get involved with alternative payments as Medicare moves to replace fee-for-service, explained Hymin Zucker, MD, chief medical officer of the Triple Aim Development Group.

Payment policy, health plan characteristics, and Medicare beneficiary characteristics come together to foster continued growth in the Medicare Advantage program.

Early sign-ups are strong under ACA; new food safety rules become final; report finds poor access to HIV drugs.

According to the CDC, while smoking rates are seeing a steady decline, rates for uninsured and adults on Medicaid are more than twice those for adults with private health insurance.

The scandal-plagued VA gave performance-based bonuses of over $140 million in 2014.

Colorado could be the first state to implement a single-payer healthcare system and opt out of the Affordable Care Act with voters deciding on the issue next year. But the issue is not without controversy.

A forced closing of Health Republic Insurance of New York has left many in need of immediate coverage.

What we're reading, November 11, 2015: annual flu shots may reduce the effectiveness of the vaccine; Democrats call for changes to the so-called Cadillac tax; and Millennium Health files for chapter 11 bankruptcy.

The ultimate goal of the research that will be published in the pages of AJMC and elsewhere over the next decade is to provide those on the ground involved in health reform implementation and health systems redesign with critical, timely evidence in order to make mid-term corrections in the redesign of the US health system going forward.

Success in marketplace enrollment under the Affordable Care Act has varied widely during the open enrollment periods, although some similar factors contributed to high enrollment rates in these 5 states.

What we're reading, November 10, 2015: half of California's illegal immigrants would be eligible for Medi-Cal if it was expanded; women are less likely to receive optimal care after a heart attack, which accounts for survival gap; and Hawaii's residents face long wait times to sign up for health coverage on HealthCare.gov.

Americans with veterans or military health, Medicare, and Medicaid have a higher satisfaction with the way the healthcare system works for them. People on plans purchased through the Affordable Care Act exchanges are the least satisfied of insured groups.

What we're reading, November 9, 2015: Americans worry patient-centered care is a gimmick; insurers raise new concerns over the increasing prices for generic drugs; and President Obama challenges 20 cities to sign up the most uninsured on the exchanges.

This week in managed care Kentucky elected a new governor who could bring big changes to the state's Medicaid program, researchers reported that costs of dementia in the last 5 years of life surpass even cancer, and the latest Hospital Safety Score report was released.

When accountable care organizations first started forming, the country thought it would be easier than it has been, but finding the right partner is crucial, said Pam Halvorson, regional vice president of clinic operations with Trinity Pioneer ACO.

The Supreme Court has decided to hear a challenge from religious nonprofits who say the Affordable Care Act's requirement to provide birth control violates their religious beliefs.