- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
What We're Reading: 2 More Co-Ops Sue Obama Administration
What we're reading, August 2, 2016: co-ops in New Mexico and Massachusetts sue the government over the risk-adjustment formula and why hospital ratings should be viewed with a bit of skepticism.
Co-ops in New Mexico and Massachusetts are suing the Obama administration over the management of the program. The states join Maryland, which filed a similar lawsuit in June, arguing that the “risk adjustment” formula overly rewarded big insurers, reported The Wall Street Journal. The co-ops are alleging that CMS hindered their success through the risk-adjustment program. The executives are saying they shouldn’t have to make payments to the government for 2015 based on the current system.
CMS recently released its “Star” ratings for hospital quality, but hospital ratings should be viewed with a bit of skepticism. While information may seem objective, the data points used and how they are weighted can lead to contradictory conclusions, STAT explains. Furthermore, opponents of CMS’ rating system have already made the case that the system penalizes hospitals that treat more low-income patients.
Review Emphasizes Potential Infection Risks With BTK Inhibitors
November 2nd 2024Although Bruton tyrosine kinase (BTK) inhibitor monotherapy in chronic lymphocytic leukemia (CLL) has been a game-changer, patients have significantly increased risks of infection, especially in the upper respiratory tract.
Read More
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.
Listen
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.
Read More
