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Correcting The Blind Spot In Accountability: The Role Of Pharmacy Care
CMS stated that they seek recommendations about how the ACO program might evolve to "encourage greater care integration and financial accountability."
The Centers for Medicare and Medicaid Services (CMS) recently issued a Request for Information (RFI) to solicit suggestions about how to improve the Accountable Care Organization (ACO) programs. CMS stated that they seek recommendations about how the ACO program might evolve to “encourage greater care integration and financial accountability.”
The RFI explicitly stated that they seek information about how to better integrate Part D expenditures into ACO cost calculations to make pharmaceuticals part of the approach to care delivery and health care transformation.
The deadline for comments about encouraging Part D integration in ACOs has now passed. But the issue extends beyond ACOs. In addition, bundled payments and patient-centered medical home programs target hospitals and primary care providers to promote higher quality and lower cost care. All these programs have largely excluded prescription drug costs in their calculus, and offer no direct incentives for Part D plans to participate in and improve care.
Read the full story here: http://bit.ly/1jirpoa
Source: Health Affairs
Medicaid Budget Survey Highlights Postpandemic Challenges and Priorities
October 24th 2024The Medicaid budget survey for fiscal years 2024 and 2025 revealed state predictions are expecting a decline in Medicaid enrollment and an increase in spending next year due to the end of pandemic-era policies and federal funding.
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Exploring Racial, Ethnic Disparities in Cancer Care Prior Authorization Decisions
October 24th 2024On this episode of Managed Care Cast, we're talking with the author of a study published in the October 2024 issue of The American Journal of Managed Care® that explored prior authorization decisions in cancer care by race and ethnicity for commercially insured patients.
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Frameworks for Advancing Health Equity: Community Wellness Centers
September 27th 2024Delia Orosco, MS, director of Community Wellness Centers at Inland Empire Health Plan, shares insight into innovative initiatives provided by the wellness centers and their new mobile mammogram clinics.
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