The US Senate hosted a panel addressing physician and health care shortages and efforts to increase minority representation in the medical field. An expert discussed initiatives to prevent senior homelessness. Advocates called for the repeal of the Comstock Act. Regulatory reforms are called for to improve rural cancer patients' access to pharmacies. Research reveals the impact of denials on patient access to immunology treatments.
Panel Addresses Minority Physician Shortage, Maternal Health at Senate Committee Hearing
During a recent Senate hearing led by the US Senate Committee on Health, Education, Labor, and Pensions (HELP), chaired by Sen Bernie Sanders (I, Vermont) and co-led by Sen Bill Cassidy, MD, (R, Louisiana) the critical issue of physician and health care worker shortages in the US, particularly the underrepresentation of minority doctors, was addressed. Sanders and Cassidy highlighted disparities present in medicine and medical school and gave the minority physician panel a platform to share insight. Panelists discussed barriers to medical education, financial burdens, and the importance of inspiring minority communities to pursue health care careers. Efforts to increase minority representation, particularly utilizing historically black colleges and universities, were recognized, with calls for increased funding to reduce costs and empower future generations of diverse physicians.
What Is a Health Plan’s Role in Preventing Homelessness Among Seniors?
The US Supreme Court examined whether an Oregon town could penalize sleeping outdoors due to insufficient affordable housing. Californian voters passed a measure mandating housing and drug treatment funding for combating homelessness. SCAN Health Plan unveiled efforts to prevent senior homelessness amid a pandemic-induced surge, highlighting successful models of care and engagement in its Environmental, Social and Governance Report. CEO Sachin H. Jain, MD, explained SCAN's initiatives, like the Healthcare in Action program providing "street medicine" to seniors experiencing homelessness, showcased tangible impacts. Jain acknowledged mixed sentiments regarding health care's expanding role in addressing social needs, emphasizing systemic issues like poverty and housing affordability. Despite concerns about healthcare's capacity to fulfill broader societal needs, SCAN's integration of social determinants of health demonstrated effective managed care tailored to homeless populations.
Congress Urged to Repeal Comstock Act Threatening Reproductive Rights and Public Health
In a joint letter to Congress, Healthcare Across Borders, Take Back the Court Action Fund, and UltraViolet Action called for the repeal of the Comstock Act, an outdated law posing a threat to reproductive rights and public health in the US. Following the US Supreme Court's overturning of Roe v Wade in June 2022, restrictive abortion bans have proliferated across states, leading to dire consequences, including increased rates of pregnancy-related complications and denial of emergency care. Although the Comstock Act, enacted in 1873 as an "antiobscenity" law, hasn't been enforced federally for abortion-related matters since the 1930s, its vague language could extend to impact access to contraception, HIV prevention, and gender-affirming care.
In this episode of Managed Care Cast, The American Journal of Managed Care® (AJMC®) engages in a conversation with Pankaj Kumar, MD, and Stephanie Parker, PharmD, from Illinois CancerCare, who authored a commentary titled "Access Denied: CMS’ Action Hurts Patients With Cancer in Rural America," published in the May 2024 edition of AJMC. The discussion delves into recent CMS regulations that have impeded rural cancer patients' access to medically integrated pharmacies, highlighting the critical need for regulatory reforms to address this issue. Through their commentary, Kumar and Parker shed light on the challenges faced by rural communities in accessing essential cancer care services and advocate for policy changes to ensure equitable access to health care for all patients, irrespective of their geographic location.
Research Shows Prior Authorization Denials Delay Critical Immunology Care
A recent study presented at the Academy of Managed Care Pharmacy (AMCP) 2024 annual meeting examined the impact of prior authorization (PA) rejections on patients requiring immunology treatments, revealing significant disparities influenced by social determinants of health. Analyzing pharmacy claims for over 260,000 patients with commercial insurance over a 52-week period, the study found that initial PA rejections were more common among males and younger patients, particularly those under 18, who were also more likely to eventually overcome these rejections. The study highlighted the time and financial burden placed on patients by PA rejections, with delays in treatment initiation and increased out-of-pocket costs.
Check out all of AJMC's coverage from the AMCP meeting.
New AI Tool Identifies Undiagnosed PNH in Health Records
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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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Overhauling Quality Measurement in the US: Measure What Matters
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