Top managed care stories this week include comparing US healthcare spending and outcomes to other wealthy nations, identifying how many Americans are affected by Medicaid expansion coverage gaps, and a look at adolescents and young patients with cancer.
Transcript (slightly modified for readability)
Hello, I’m Justin Gallagher, associate publisher of The American Journal of Managed Care.
Welcome to This Week in Managed Care, from the Managed Markets News Network.
US Healthcare Spending
High spending on healthcare doesn't guarantee results, at least not in the United States—that's what researchers found in a study this week published by The Commonwealth Fund. Among wealthy nations including Canada, Denmark, Germany, and France, the United States spends more but has some of the worst health outcomes including a lower life expectancy. US healthcare spending per person average $9086 with life expectancy at 78.8 years. Switzerland, meanwhile, spends only $6325 per person and has an average life expectancy of 82.9 years. US rates for cancer, chronic conditions like diabetes, obesity, and infant mortality are all higher than other countries.
Said Commonwealth Fund President Dr David Blumenthal, "Time and again, we see evidence that the amount of money we spend on healthcare in this country is not gaining us comparable health benefits."
Coverage Expansion Gap
As we head into the third open enrollment period under the Affordable Care Act, a new study by the Kaiser Family Foundation shows that about half of the 32 million Americans who remain uninsured are eligble for either Medicaid or tax credits through the marketplace exchanges. But for 10% of the uninsured, about 3.1 million, health insurance could be out of reach. That's because they live in states that have not expanded Medicaid and they fall in the coverage gap. They earn too much for traditional Medicaid, but not enough to qualify for coverage on the exchanges.
States with the highest number of households in the coverage gap are Texas, Florida, Georgia, North Carolina, and Louisiana. However, Louisiana elects a new governor this fall and is expected to expand Medicaid for 2016.
Cancer Survivor Point of View in EBO
The new issue of Evidence-Based Oncology addresses the special needs of adolescent and young patients with cancer. In this issue, we hear from Woody Roseland, a 25-year-old survivor who has had 8 separate bouts with cancer. Roseland's essay, "Picking Up the Pieces," is one of the most read items this week. Read it here.
For the Managed Markets News Network, I’m Justin Gallagher. Thank you for joining us.
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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Uniting to Support Patients With Cancer Beyond Treatment
November 17th 2024Kasey Bond, MPH, of Perlmutter Cancer Center at NYU Langone Health, speaks to why it’s vital to keep patients at the center of all strategic partnerships between academic institutions and community-based oncology practices.
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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 Cancer Care Gaps and Overcoming Medical Mistrust
November 13th 2024In this clip from our interview with Oscar B. Lahoud, MD, cochair of our Institute for Value-Based Medicine® evening hosted with NYU Langone Health, he addressed medical mistrust in underrepresented communities.
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How English- and Spanish-Preferring Patients With Cancer Decide on Emergency Care
November 13th 2024Care delivery innovations to help patients with cancer avoid emergency department visits are underused. The authors interviewed English- and Spanish-preferring patients at 2 diverse health systems to understand why.
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