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What We’re Reading: Preventable Maternal Mortality; Centene Settles Lawsuit; Hopkins May Stop Accepting CareFirst
A recent CDC report found that 80% of pregnancy-related deaths are preventable; Centene will pay $166 million to Texas in Medicaid pricing settlement; Johns Hopkins has warned that it may no longer accept CareFirst insurance after December 5.
CDC Data Reveal Frequency of Preventable Pregnancy-Related Mortality
The CDC found that more than 80% of pregnancy-related deaths are preventable, according to data from 2017 to 2019 compiled by the Maternal Mortality Review Committees (MMRCs) in 36 states. Of the pregnancy-related deaths with information on timing, 22% occurred during pregnancy, 25% occurred on the day of delivery or within 7 days, and 53% occurred between 7 days and 1 year after pregnancy. The leading causes of pregnancy-related deaths included mental health conditions, excessive bleeding, cardiac and coronary conditions, infection, thrombotic embolism, cardiomyopathy, and hypertensive disorders. The MMRCs have recommended wider access to insurance coverage and providing opportunities to receive better transportation to care.
Centene to Pay $166 Million to Texas to Settle Lawsuit
The health insurance group Centene Corporation will pay Texas $166 million to settle a lawsuit on Medicaid drug pricing. Centene is currently the largest Medicaid managed care insurer in the country, with 15.4 million enrolled in the system nationwide. This settlement is not the first of its kind, as several states have accused Centene of overbilling their Medicaid programs for prescription drugs and pharmacy services. Although the number of states that have accused Centene is not publicly known, the company had already settled with Arkansas, Illinois, Kansas, Mississippi, New Hampshire, New Mexico, Ohio, and Washington before settling with Texas.
Hopkins Warns of Potential Departure From CareFirst Network
Johns Hopkins warned approximately 300,000 patients that their doctors may stop accepting CareFirst BlueCross BlueShield insurance starting December 5. The warning comes as Hopkins and CareFirst stand at an impasse on negotiations begun in June on rates that the insurance company pays. The contract currently covers approximately 4000 providers at the Johns Hopkins flagship hospital, Bayview Medical Center, Howard County General Hospital, Suburban Hospital, and Sibley Memorial Hospital. Stand-alone ambulatory surgery centers would also be affected by this development. If Hopkins and CareFirst cannot reach an agreement by March 5, which would leave hospital stays uncovered, the Hopkins hospitals in Maryland may also leave the network.
PAH Treatment Outcomes Similar Regardless of Diagnosis Time
November 1st 2024The study findings underscore the importance of early initiation of macitentan and tadalafil among patients who have pulmonary arterial hypertension (PAH), and represent a shift in understanding of prognosis based on diagnosis timing.
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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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