Health Care Delivery

A one-minute look at managed care news during the week of April 27, 2015, including more good news for the much-anticipated PCSK9 inhibitors and growth in the individual insurance market enrollment.

In 2014, low- and moderate-income consumers were able to use premium subsidies to buy health coverage on Marketplaces under the Affordable Care Act. The individual health insurance market had been relatively flat for 3 years' prior.

Accessing patient information in a health information exchange system during the 30 days after hospital discharge reduced the odds of readmission, according to a study in the Journal of the American Medical Informatics Association.

Although the Supreme Court oral arguments of King v. Burwell mostly went the way people were expecting, there were a few surprises, said Thomas P. Miller, JD, resident fellow at the American Enterprise Institute, who was able to sit in the courtroom the day of the arguments.

Although practices saw a decrease in patient visits during the 2 years after electronic health record implementation, they reported an increase in revenue during that same time period, according to a study in the Journal of the American Medical Informatics Association.

House Republicans say that Medicaid takes up too much of the state's budget for them not to have more say in who receives it. They also included budget language calling for Medicaid officials to ask CMS to allow healthcare savings accounts for almost all beneficiaries.

Industry experts at the National Association for Healthcare Quality's National Quality Summit highlighted improving care through successful care transitions.

Studies have shown that embedding behavioral health services into the primary care practice produces better health outcomes for patients with diabetes, while reducing indications of depression. The challenge is figuring out how to make the transition to new payment models that reward such care.

A study of the use of patient portals among older Americans found clear disparities in the registration and use of this technology. The results were published in the Journal of the Americans Medical Informatics Association.

In a new survey, more than half of self-identified Republicans said they didn't think the Affordable Care Act is increasing the number of people with health insurance, with a fifth of respondents saying it has actually reduced the number of people with coverage.

Medicaid managed care is expanding throughout the United States. Iowa is going through a request-for-proposal process, and Kentucky is rebidding its contracts after switching over to managed care in 2011.

The federal government's review of how much money it spends to help pay for the hospital costs of low-income people in Tennessee and other states that didn't expand Medicaid feels like a threat to Governor Bill Haslam.

Satisfaction with the Health Insurance Marketplace exchange enrollment process among new enrollees has significantly increased from 2014.

Patients with multiple long-term health conditions are more likely to report poorer experiences in primary care than those with fewer health problems, according to recent findings by researchers from the University of Cambridge and RAND Europe.

States increasingly use managed care for Medicaid enrollees, yet evidence of its impact on healthcare outcomes is mixed. This research studies county-level Medicaid managed care penetration and healthcare outcomes among nonelderly disabled and nondisabled enrollees.

Researchers from the University of Washington examined drinking patterns down to the county level, and found wide disparities within state borders. This suggests that solutions to problem drinking must be found locally.

Avalere, partnering with the National Comprehensive Care Network, surveyed 20 cancer centers and found that 75% of respondents were covered by at least "some" of the exchange plans in their state.

Accountable care organizations were created under the Affordable Care Act to improve healthcare delivery to a defined population. As writers in the new issue of Evidence-Based Oncology discuss, while palliative care exists to raise the quality of life for the seriously ill, it can also speak to the value equation of delivering care that patients want at a lower cost.

Oncologists are slightly less satisfied with their specialty than they were a few years ago, according to the fifth consecutive annual Medscape report.

The system lets consumers pay cash at store register, while clerks scan bar codes sent to their cell phones. The system replaces these consumers sending in money orders each month.

The Kaiser Health Tracking Poll found Americans strongly support ensuring that those with chronic conditions like cancer, HIV, and mental illness can have access to affordable drugs, and this sentiment was shared across partisan lines.

Fifteen states are betting they can convince more doctors to accept the growing number of patients covered by Medicaid with a simple incentive: more money.

In its third year, Patient-Centered Diabetes Care, which took place April 16-17, 2015, in Boston, showed how new payment models, new therapies, and new approaches to patient engagement are changing care for persons with diabetes. The American Journal of Managed Care and Joslin Diabetes Center presented this year's meeting.

Missouri already spends $1.2 billion on Medicaid managed care in less than half its counties. The new plan would extend managed care to all Medicaid clients except the blind, disabled, and elderly. Meanwhile, in North Carolina, the CEO of the Medical Society argued against moving Medicaid to managed care, citing problems in other states.

Despite its rocky launch, the federal health insurance exchange did better than the exchanges run by individual states at both enrolling new people in Obamacare and hanging onto previous enrollees, according to a recent analysis.

The national divide over the Affordable Care Act is beginning to affect Americans' access to medical care and perhaps even their ability to pay medical bills, a new study of the country's 4 largest states suggests.

In Montana, 13 Republicans helped give a Medicaid expansion bill a solid majority to send it back to the Senate for reconciliation. A bill signing could come by next week. In Florida, Governor Rick Scott appeared to reverse his 2013 position that he could not deny the uninsured access to care.

Although the Affordable Care Act has helped more people gain access to healthcare coverage, including those with pre-existing conditions such as cancer, the survey by the Cancer Support Community found that the cost of care is still too high for many cancer patients.