November 21st 2024
Lindsay Bealor Greenleaf, JD, MBA, discusses how the appointment of Robert F. Kennedy Jr as HHS secretary could affect health care services in the future.
Value-Based Care Through Postacute Home Health Under CMS PACT Regulations
Among a patient population defined by CMS postacute care transfer regulations, home health vs no postacute care was associated with reduced 30-day readmissions and costs.
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Lymphoma Research Foundation CEO on Biden’s Cancer Moonshot, Financial Toxicity
February 3rd 2022On this episode of Managed Care Cast, we speak with Meghan Gutierrez, CEO of the Lymphoma Research Foundation, about financial toxicity, how the pandemic has affected patients’ financial needs when they have cancer, health care disparities and care gaps, and more.
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Mental Health Service Utilization Review Patterns in a Medicaid Managed Care Program
Medicaid managed care utilization review data for mental health services were analyzed for the calendar years 2017 and 2018. These data indicate low rates of utilization review denials for both inpatient and outpatient mental health services.
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Has the Time Arrived to Incorporate Genetic Testing Into Health Care?
February 2nd 2022The rise in popularity of genetic testing brings along a myriad of challenges ranging from concerns on data privacy to insurance coverage, but, when utilized correctly, it could mark a step forward for significant advancements in individual and population health.
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COA Survey: Practices Find OCM a Success; Some Added Services May Be at Risk
January 31st 2022The Oncology Care Model (OCM) is set to expire June 30, 2022. With no successor on the horizon, respondents to a recent survey by the Community Oncology Alliance (COA) say features such as dedicated navigators and weekend appointments could be reduced or lost if revenues that supported them are eliminated.
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Number of Accountable Care Organizations Joining MSSP in 2022 Grew Slightly, CMS Says
January 26th 2022In its annual Medicare Shared Savings Program (MSSP) report, CMS said the number of accountable care organizations joining increased, but a trade group said the results should have been better.
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A study found 4 factors may correlate with increased risk of long-term COVID-19; Rhode Island joins opioid settlement against McKesson, AmerisourceBergen, and Cardinal Health; the Environmental Protection Agency announced it will station mobile equipment in Louisiana to measure air pollution.
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What We’re Reading: FDA Pick Advances; Recent Years Hottest Yet; Some Omicron Cases Slow
January 14th 2022Senate panel votes to advance Robert Califf, MD, as the new head of the FDA; rising global temperatures spell increased health challenges; Omicron cases may be peaking in some Northeast cities.
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CMS Says It Will Limit Biogen’s AD Drug to Patients in Clinical Trials
January 11th 2022In a National Coverage Determination decision memo released Tuesday, CMS said it will gather public comment for 30 days about its plan to limit coverage for Alzheimer disease (AD) biologics that target plaque buildup in the brain to patients enrolled in certain clinical trials.
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Gaps Persist in Physicians' ADA Knowledge
January 11th 2022On this episode of Managed Care Cast, we interview the lead author of a paper in the January issue of Health Affairs about what physicians know and don't know regarding their responsibilities to accommodate patients with disabilities when they come in for an office visit.
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CDC Clarifies New COVID-19 Isolation Protocol, Outlines Efforts to Protect Children
January 7th 2022CDC officials clarified the agency's new isolation recommendations for individuals infected with COVID-19 and provided updates on its efforts to reduce pediatric cases among those too young to receive vaccines.
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The Biden administration doubled its order of Pfizer’s COVID-19 antiviral drug; California is now the first state to require health insurance plans to cover at-home STI tests; the Supreme Court will hear in-person arguments Friday to decide whether to block federal vaccine mandates.
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Growing Acceptance of Cannabis Leads to Concern About Future COPD Cases, Says Dr Don Sin
December 27th 2021With legalization of cannabis across much of the United States and all of Canada, Don Sin, MD, FRCP, MPH, a professor of respiratory medicine at the University of British Columbia and head of the Centre of Heart Lung Innovation, St. Paul’s Hospital, has concerns about the effect of wider cannabis usage on chronic obstructive pulmonary disease (COPD) in future decades.
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