Health Care Delivery

Parents in low-income families were less likely to delay asthma care for their children or avoid taking their children to see a doctor is they had lower vs. higher levels of health insurance cost-sharing.

Few states could claim Obamacare's first enrollment period was smooth-whatever the final numbers-but most will approach their insurance exchanges the same way for the 2015 window. None has asked the Obama administration to take over its marketplace or elected to abandon HealthCare.gov in favor of running its own.

The CMS on Friday issued its final rule for exchange and insurance market standards for 2015 and beyond, a potpourri of policies that address consumer notices, quality reporting and enrollee satisfaction surveys, the Small Business Health Options Program (SHOP), standards for navigators and other consumer assisters, and policies regarding the premium stabilization programs, among others.

Using mystery shoppers looking for access to health care, Public Health Seattle & King County has found troubling indications that access to primary-care providers may not be as advertised.

NCCN Guidelines Updates

Avik Roy, senior fellow, Manhattan Institute, says that the problem with the community rating provision is that age bands can make insurance costly for young patients.

The American Journal of Managed Care will host the first gathering of its ACO and Emerging Healthcare Delivery Coalition this week in Baltimore, Md. The ACO Coalition aims to share best practices for setting up successful ACOs.

Many state legislators remain wary of the costs associated with expanding their Medicaid programs under the Affordable Care Act (ACA). However, a new report from the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) that details the budgetary effects of the ACA said differently.

A left-leaning think tank whose research is often taken seriously by backers of the health-care overhaul has published a paper suggesting the administration should scrap the health law's requirement that employers offer coverage or pay a penalty.

Enrollees in some of the health law's most popular plans will face high cost-sharing requirements that the pharmaceutical industry says could keep patients from getting the drugs they need.

Roger Kathol, MD, president of Cartesian Solutions, Inc, and professor of internal medicine and psychiatry at the University of Minnesota, says that health reform presents several opportunities for psychiatrists.

The Obama administration says the number of Medicare patients returning to hospitals within 30 days fell further in 2013, amounting to 150,000 fewer readmissions since January 2012.

The former Congressman discussed his goal of finding common ground on what constitutes mental health while at the 167th Annual Meeting of the American Psychiatric Association.

Hospitalists to field changes in patient care delivery, health policies propelled by Obamacare for decades.

Patrick J. Kennedy, former US Representative for Rhode Island's 1st Congressional District, says that he authored the Mental Health Parity & Addictions Equity Act in 2008, which was then incorporated into the Affordable Care Act in 2010. The parity law went into effect in January 2014, and by 2015, more health plans are expected to be covered under it.

The Affordable Care Act's (ACA) promise of broader availability of healthcare coverage, coupled with a federal law aimed at ensuring that mental health coverage is on par with that of other items in a plan, should mean that those with mental health disorders will finally get better care, right?

Despite the considerable resources designated to PCORI, its future remains tenuous.

States did little to improve healthcare access, quality, costs and outcomes in the past five years, according to a Commonwealth Fund report. Researchers examined 42 health indicators between 2007 and 2012, and found that in many states, access and affordability of healthcare actually declined among adults younger than 65. Healthcare spending rose $491 billion, reaching $2.8 trillion nationally.

The Federation of State Medical Boards approved a model telehealth policy this weekend that's made some providers of these services happy and others, well, not so much, because of its emphasis on using video rather than audio technology for a first patient visit.

Value-based insurance design (V-BID) encourages providers to deliver higher quality services at lower out-of-pocket costs for patients, and it is increasingly gaining bipartisan support in Congress.

The White House sought to quash any fear that Obamacare is reversing downward trends in health spending as very preliminary estimates for U.S. economic growth in the first months of 2014 suggested spending on healthcare is rebounding sharply.

The American Journal of Managed Care publishes a first-of-its-kind study comparing different types of health insurance plans and different levels of co-payment, to see how varieties of coverage affect access to therapeutic drug classes.

Despite a growing number of people becoming insured in 2014, attitudes have not shifted about the Affordable Care Act.

Among surprises from a new study on U.S. health spending is the realization: Whether insured or not, young adults spent about the same on out-of-pocket health expenditures throughout the year.

In the opening presentation of the National Association of Managed Care Physicians' Spring Managed Care Forum 2014 in Orlando, entitled Are You Ready for Value-Based Payment, Christopher Kalkhof, FACHE, and Amol Navathe, MD, discussed their work assisting healthcare organizations to optimally strive for sustainable business models that will prevent margin erosion during a time when the population of healthcare consumers is increasingly aging and using more resources associated with chronic disease and end-of-life treatments.

Providers and insurers alike know that focusing on quality and cost will be essential, especially as healthcare shifts toward accountable care models.

Despite enrollment deadline extensions and expansion of the federal poverty guidelines, many uninsured Americans are choosing not to obtain health plans on insurance exchanges.

The expenses associated with cancer care in the United States are staggering and only expected to climb.

While lawmakers initially had intended to have each state run its own health insurance exchange, only 16 states and Washington, DC, have opted to do so. Many now wonder if the remaining states will establish their own exchange, as the November deadline to receive federal grant funding approaches, or if they will simply default to utilizing a federally-run exchange.