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What We're Reading: ACA Stability; Opioid Court; Uber Replacing Ambulance Rides
Credit rater predicts Obamacare insurers will have a relatively stable 2018; Buffalo, New York, has the country's first opioid court aimed at saving lives; ambulance rides are down in cities with Uber.
Analysts Predict a Stable Year for ACA Insurers
Credit rater A.M. Best is predicting that the Affordable Care Act (ACA) insurance markets will have a relatively stable 2018 as insurers have adapted to the uncertainty presented by the Trump administration. The Hill reported that insurers have benefited from high rate increases, limited competition, and a stabilizing population in the exchanges. In addition, the analysts at the credit rater believe Congress will not focus on trying once again to repeal the ACA.
The Nation’s First Opioid Court
Unlike typical drug courts, the nation’s first opioid court, in Buffalo, New York, recognizes that failure is part of recovery. Some of the criminal defendants entering the courtroom in Buffalo are taking part in an experimental program, The New York Times reported. The goal of the program is simple: save lives as the opioid epidemic continues. The court’s judge is a former drug user who requires participants of the program to appear daily. The program started in May 2016, and to date only 1 of the 92 participants has died from an overdose.
Patients Call Uber, Not the Ambulance, for ED Trips
More and more patients are using ride-sharing apps, such as Uber, to get a ride to the emergency department (ED) instead of paying the high cost of an ambulance ride. According to Forbes, per capita ambulance usage volume is down at least 7% in the cities that have Uber. However, while Uber may be a cheaper alternative, it should only be used for low-risk patients who are stable, but too sick to drive themselves. Using a ride-sharing app to get to the ED can benefit more than the insurance company and the patient—when low-risk patients use Uber, it can reduce the overall wait times for an ambulance so patients in a true emergency situation can get lifesaving care quicker.
Urticaria Diagnosis Challenged by Overlapping Pruritic Skin Conditions
April 23rd 2025Urticaria is complicated to diagnose by its symptomatic overlap with other skin conditions and the frequent misclassification in literature of distinct pathologies like vasculitic urticaria and bullous pemphigus.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz
April 23rd 2025Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
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