Health Care Delivery

As enrollment in Medicare Advantage is expected to increase to a new all-time high for the sixth year in a row, CMS announced that Medicare Advantage premiums will remain stable in 2016.

The implementation of the Affordable Care Act (ACA) has reduced the number of uninsured Americans and created significant gains in health coverage among racial and ethnic minorities. However, the ability of Obamacare to reduce racial and ethnic disparities has been limited.

An analysis of the competitive landscape of the public health insurance exchanges as it has so far unfolded has revealed that despite challenges to date, the exchanges have been attracting new entrants.

The top stories in managed care include the nomination for the next FDA commissioner, a report reveals cancer drugs are driving growth in the 340B program more than initially thought, and nearly half a billion in ACA funds are made available to health centers.

As the United States looks to reform its healthcare system to provide better value at lower costs, the real challenge is innovating at scale across the country, said Joseph Gifford, MD, chief executive officer of the Providence-Swedish Health Alliance.

Many hoped the 2013 declaration by the American Medical Association that obesity is a disease would open the door to improved coverage for pharmcotherapy. That did not happen right away, but signs of change are emerging.

The path to President Obama's Precision Medicine Initiative has been paved as is evident from a report released by a Working Group convened by the National Institutes of Health.

While employers will continue to shift healthcare costs to employees, a new report found that the underlying cost growth, which employers would expect if they did not make changes such as raising deductibles or switching carriers, will slow in 2016.

At the recently held NCCN healthcare policy summit in Washington, DC, experts delved into various models being evaluated to reduce healthcare utilization in oncology care.

Healthcare policy makers, payers, medical centers, and patient representatives shared the dais as they discussed The Value Proposition in oncology.

The report included some famous examples of states that had to abandon early IT efforts despite large sums spent

Nearly half a billion dollars in Affordable Care Act funding will be awarded to health centers around the country to help them provide primary care services to those who need them most.

Unaccounted for social and clinical characteristics of a hospital's patient population explain nearly half of the difference in readmission rates between the best and the worst performing hospitals when it comes to Medicare penalties for hospital readmission rates.

Healthcare policy experts gathered in Washington, DC, to discuss access, cost, and the definition of value in oncology care.

Healthcare practitioners are well aware that the rising cost of medical advances may affect their ability to deliver great care to all their patients, but there are ways they can address the issue, said Joseph Alvarnas, MD, the editor-in-chief of Evidence-Based Oncology.

People with insurance have significantly higher probabilities of being diagnosed for diabetes, hypercholesterolemia, and hypertension than people without insurance.

The top stories in managed care this week include value-based pricing of the new PCSK9 inhibitors, CMS unveiled a new health equity plan for Medicare, and the American Medical Association released analyses on proposed health insurance mergers.

Creating a statement that mental health and physical health have parity is important for achieving outcomes in patients with chronic illnesses, said Trishan Panch, MBBS, MPH, chief medical officer at Wellframe.

House Republicans won a minor victory in a new lawsuit against the Obama administration for the legality of spending money from the Treasury for health insurers under the Affordable Care Act. Arguments will be heard this fall.

Kim Thiboldeaux, chief executive officer of the Cancer Support Community, discusses the importance of providing strong community support, the misconceptions of clinical trials, and creating a tailored care plan.

At the end of CMS' comment period, the American Society of Clinical Oncology submitted its comments and recommendations for the proposed changes.

The California Public Employees' Retirement System saved $7 million on screening colonoscopies during a 2-year period following implementation of reference pricing.

CMS has released a new plan to address health equity in Medicare, which includes 6 priority areas aimed at reducing health disparities over the next 4 years.

With the comment period ending today, the proposed CMS cuts to radiation oncology reimbursement rates might have a substantial impact on community treatment centers.

For individuals who have not made the sort of risk-averse decisions in their lives that lead to better jobs and wealth accumulation, making treatment decisions after a cancer diagnosis can be very difficult, said Amy Davidoff, PhD, MS, senior research scientist in public health at the Yale School of Public Health

An analysis of Medicare Advantage (MA) plan market shares finds little competition in counties across the nation, according to a report published by The Commonwealth Fund.

Predictive modeling determined that the needle exchange in Washington, DC, prevented 120 new cases of HIV in 2 years, according to researchers.

HHS is seeking new protections for vulnerable populations to protect them from discrimination and ensure they have equal access to healthcare and health coverage.

The difference between "heart age" and chronological age indicates risk of events like heart attacks and strokes, and could motivate younger patients to improve unhealthy lifestyles.

Leah Binder, president and CEO of The Leapfrog Group, will be the keynote speaker at the upcoming meeting of the ACO and Emerging Healthcare Delivery Coalition, to be held October 15-16, 2015, in Palm Harbor, Florida. The Coalition, an initiative of The American Journal of Managed Care, brings together stakeholders from across healthcare to share ideas for navigating the changing reimbursement landscape.