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Managed Care Minute: March 14, 2015
A one-minute look at managed care news during the week of March 9, 2015, including a new ACO model from CMS and the increase in drug spending driven largely by hepatitis C and compounded medications.
CMS continued its move to value-based payment with the announcement of a new ACO model that takes on greater performance risk with potentially greater reward.
Prescription drug spending was up 13.1% in 2014 with hepatitis C and compounded medication driving more than half of the increase, reported Express Scripts. Specialty drugs also accounted for half of drug spending.
Emergency department use among young adults has gone down, which is attributed to letting people stay on their parents’ health insurance until age 26.
Finally, Jeffrey McCullough, PhD, will be the guest editor-in-chief for The American Journal of Managed Care’s 5th Annual Special Issue on Health Information Technology. View the call for papers.
ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz
April 23rd 2025Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
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Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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Bridging Care Gaps With a Systemwide Value-Based Care Strategy
March 29th 2025Mapping care management needs by defining patient populations and then stratifying them according to risk and their needs can help to spur the transformation of a siloed health care system into an integrated system that is able to better provide holistic, value-based care despite the many transitions that continue among hospital, primary, specialty, and community care environments.
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