Health Care Delivery

One month into open enrollment on the health insurance exchanges, HHS Secretary Kathleen Sebelius apologized for what she described as a "miserably frustrating experience for way too many Americans" on the federal online marketplace known as HealthCare.gov.

After focusing for weeks on the technical failures of President Obama's health insurance website, Republicans on Tuesday broadened their criticism of the health care law, pointing to Americans whose health plans have been terminated because they do not meet the law's new coverage requirements.

Consumers who buy a health insurance policy good for only 364 days might save hundreds of dollars in premiums, but they could also find themselves without important benefits and charged a penalty for not having insurance next year.

Under PPACA, in every interaction between patients, doctors, insurers, manufacturers and researchers, the incentive to control costs and provide better service is replaced with the decree to do so.

The premiums for Medicare Part B will remain flat in 2014 and seniors have saved $8.3 billion on Part D prescriptions since the Affordable Care Act was enacted in 2010, the Department of Health and Human Services announced Monday.

Amid the havoc of a healthcare insurance exchange website overwhelmed with problems, many aired concerns as to whether the individual mandate penalty would be delayed.In addition to President Obama calling in reinforcements to address exchange technology problems, the administration announced Wednesday that it would extend the consumer enrollment deadline until March 31, 2014.

The Obama administration said Wednesday that it would delay imposing penalties for six weeks on some consumers who might have been caught in a sticky timing problem for enrolling in coverage through the health law's new insurance marketplaces.

Data now obtainable from HealthCare.gov show there are 78,437 variations of health plans throughout the 36 states covered under the federal government's troubled web site, ranging from a bare-bones policy going for $81.34 a month in Kansas for a 27-year-old, up to a so-called gold family plan with an HMO in Virginia costing $6,494.54 a month.

Millions of Americans may still log on to discover that they aren't eligible for any health coverage at all. And that won't be due to any technical glitch. It's because their state has.

We discuss our concerns about tying physician performance to CG-CAHPS scores and suggest an alternative approach to facilitate translation of service excellence into clinical practice.

By 2020, an estimated 85% of Medicaid beneficiaries are expected to be enrolled in a managed care organization a significant increase from the nearly 50% that are currently enrolled.

The American Journal of Pharmacy Benefits (AJPB) and the Pharmacy Benefit Management Institute (PBMI) today unveiled a strategic partnership between the two organizations, which will provide professionals in the pharmacy benefit management industry with free access to both AJPB and its flagship publication, The American Journal of Managed Care (AJMC).

With the US Food and Drug Administration busier than ever with breakthrough and priority review designations, and the rise of genetic-based treatments offering new hope for patients and families, the pressure is on oncologists to push the limits in care. But if it costs $200,000 to extend life just a few weeks, does that make sense? Are doctors having that conversation? When they do, are patients hearing it? These are the very issues that will be on the table in Baltimore Nov. 14-15 when The American Journal of Managed Care convenes experts from the front line.

The debt ceiling has been raised, and that means that the government will be looking for ways to control long-term budget expenditures, including those for programs like Medicare.

Social security numbers allegedly passed around in clear sight. Page after page of unworkable code. And no clarity on when it will all be fixed. Just another day of trying to log in to healthcare.gov.

Health plans are sending hundreds of thousands of cancellation letters to people who buy their own coverage, frustrating some consumers who want to keep what they have and forcing others to buy more costly policies.

At year's end, Texas will shut down its high-risk insurance pool for some of the state's sickest residents, pushing participants to find private coverage in the federal health insurance marketplace created under the federal Affordable Care Act.

Jeff Goldsmith, PhD, healthcare futurist and analyst, says that the Affordable Care Act (ACA) has significantly impacted healthcare policy, in both negative and positive ways.

Richard Stefanacci, DO, chief medical officer, The Access Group, said that it is necessary for retail pharmacists to break out of their silo. Dr Stefanacci noted that retail pharmacists are being utilized within practices and stepping out of their normal roles.

According to John McAfee one of the main problems with the Affordable Act is its technical shortfalls.

The U.S. administration has a little over a month to fix the technology problems crippling its online health insurance marketplace, or jeopardize the goal of signing up millions of Americans in time for benefits under President Barack Obama's healthcare law, experts said on Thursday.

Expansion or not, it is obvious that states must consider how to make their Medicaid programs more sustainable.

The future of healthcare is shaping into something that looks like it is out of a science-fiction movie: electronic health records, E-prescriptions, big data, and cutting-edge technologies being used in the patient procedures. So why are the healthcare insurance exchanges relying on stone-age processes?

Federal officials say they have identified and can fix the biggest flaws in their online insurance marketplace after an inaugural week marked by system outages and long wait times.

Dan Crippen, executive director of the National Governors Association, says the single biggest issue with state Medicaid programs is its significant impact on state budgets.

Ignore the inevitable startup glitches. The new health-insurance exchanges will work just fine -- in the sense that all government health-care programs work: Many people will ultimately become dependent on them for coverage. That won't mean the exchanges have fulfilled their promise, however.

There's a Medicare prescription-drug coverage abyss that is playfully referred to as the "doughnut hole," though there is nothing sweet or amusing about it.

As the government shutdown drags on, patients and providers are feeling the strain.

From the Physician Quality Reporting System's aim to boost quality measures reporting to the potential for accountable care organizations to transform care delivery, this brief sheds light on these and other key ACA provisions impacting cancer care.