Medicare to Hit 2,211 Hospitals for Readmissions

Osteoarthritis leads the burden, projected to affect 50% of postmenopausal women by 2045.

Delays, denials, and endless paperwork—prior authorization isn’t just a headache for providers; it’s a barrier for patients who need timely care, explains Colin Banas, MD, MHA, chief medical officer with DrFirst.

Up to 257 million Americans could benefit from these prior authorization reforms that could have cross-market implications on health care plans administered through commercial insurers, Medicare Advantage, and Medicaid.

A quick roundup episode of major news and health policy developments from The American Journal of Managed Care.

Widespread noncompliance with federal cost-sharing rules exists, particularly impacting Medicare beneficiaries and patient-preferred prep options, study finds.

Discontinuing the weight loss treatment before hitting the recommended maintenance dose contributes to low-value care despite provider follow-up and efforts to manage side effects, says Hamlet Gasoyan, PhD, Cleveland Clinic.