This Year in Managed Care: 2018 Recap

From policy calls to decisions at the polls, 2018 was another year of change in healthcare.

Welcome to AJMC^®’s Year in Review, I’m Laura Joszt.

ACA News and Changes

President Donald Trump came into office promising to overturn the Affordable Care Act (ACA). While the law remains in place, our news team’s list of top stories for 2018 includes efforts to reverse what that the Trump administration sees as the restrictions of Obamacare:

• The Trump administration adopted a rule to allow short-term health plans that don’t follow all the requirements of the ACA.
• President Trump praised a federal judge who ruled on December 14 that the ACA was unconstitutional, based on the 2017 tax plan that eliminated a penalty for the individual mandate.

Amid the uncertainty over the future of the healthcare law, voters in three states approved Medicaid expansion.

With Idaho, Nebraska, and Utah joining the ranks of states that allow coverage for families earning up to 133% of the federal poverty line. Only 14 states have not approved Medicaid expansion in some form. Although several states now have rules requiring recipients to show proof of work or volunteer time.

Learn more about the status of Medicaid expansion.

Life Expectancy Declines

For the second straight year, the CDC reported that the nation’s life expectancy is dropping.

In 2017, life expectancy for someone born in the United States was 78.6 years, down from 78.7 years in 2016. At age 65, life expectancy for the total population was 19.5 years, up slightly from 2016, when it was 19.4 years.

A separate report showed that suicides and increases in drug overdoses are driving the decline in life expectancy, with sharp increases in deaths from synthetic opioids, including fentanyl and fentanyl analogs.

Read more about the CDC's life expectancy report.

Conference Coverage

Clinical trial results for a cholesterol drug and findings that could let women take less chemotherapy were among the top conference stories for 2018.

In March, we reported results for ODYSSEY OUTCOMES, which were presented at the 67th Scientific Sessions of the American College of Cardiology. Results showed that the PCSK9 inhibitor Praluent reduced deaths by 29% for those with the highest cholesterol levels.

In June, results from the TAILORx trial showed that most women with early stage breast cancer and intermediate range risk scores on the Oncotype DX breast cancer test can be treated with just endocrine therapy.

The exception are some young women with scores at the end of the intermediate range.

Read more on the TAILORx study.

Most Popular Peer-Reviewed Research

And finally, our most popular peer-reviewed study of the year in The American Journal of Managed Care^® comes from Andrew Heekin, PhD, and his coauthors at Optum on the successful implementation of Choosing Wisely protocols at Cedars Sinai Medical Center in Los Angeles, California.

The authors found that real-time decision support tools built around Choosing Wisely improved health and saved money.

Read the full study.

On behalf of the entire Managed Markets News Network, I’m Laura Joszt.

Thank you for watching us in 2018. Have a happy new year.