Senate Focuses on Drug User Fee Bill
The Senate is preparing to go on recess next week, but before it does so, it will vote on the FDA user fee reauthorization bill. According to RAPS, Senate Majority Leader Mitch McConnell (R-Kentucky) called on the Senate to renew the user fee programs and has noted the importance of doing so quickly. The FDA has said it needs those fees reauthorized or it will have to lay off thousands of employees. The House of Representatives passed its version of the bill on July 12.
Some Insurers Eye 30% Premium Increases
Facing uncertainty over the future of the Affordable Care Act (ACA) and the cost-sharing reduction payments that the Trump administration has considered not paying, some insurers are seeking high premium increases for 2018 on ACA plans, reported The Wall Street Journal. One insurer in Montana noted that 17 percentage points of its 23% increase are related to the uncertainty. In California, the average premium increase will be 12.5% next year, with 3% reflecting unease over the future. However, Anthem Blue Cross is ending coverage, leaving 10% of enrollees in Covered California to look for new coverage.
More Bipartisan Work to Shore Up the ACA
The Senate Committee on Health, Education, Labor, and Pensions is planning a series of hearings with the goal of creating bipartisan legislation to stabilize the ACA’s markets. Politico reported that the hearings will feature health policy experts, patients, and insurance industry representatives. The committee’s ranking Republicans and Democrats have both said they will include senators outside of the committee to help with the work. They will try to come up with solutions to shore up the ACA markets by mid-September.
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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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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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.
Read More
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.
Listen
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.
Listen
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.
Read More
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