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What We're Reading: Few Hospitals Receive 5 Stars in Medicare's New Ratings
What we're reading, July 28, 2016: CMS released first hospital quality ratings; Anthem is prepared to fight the government over Cigna purchase; and regulations are falling behind stem cell clinics.
Of the 3617 hospitals rated in CMS’ first hospital quality rating, just 102 received the top rating of 5 stars. According to Kaiser Health News, many of the nation’s best-known hospitals received average or below-average scores as part of the controversial rating system. Hospitals argue the ratings do not do enough to factor in the health of the patients being treated, which makes the hospitals that treat tougher cases look bad.
Anthem is prepared to fight the US Department of Justice (DOJ)’s efforts to block its acquisition of Cigna. Expecting to lose money on plans sold under the Affordable Care Act, Anthem is arguing that a merger with Cigna would let it negotiate better prices and pass savings on to consumers, reported Reuters. Last week, the DOJ sued to block Anthem’s acquisition of Cigna and Aetna’s purchase of Humana.
Although stem cell therapies are mostly theory at this point, new stem cell clinics are spreading as regulations fall behind. The New York Times blog The Upshot took a look at the world of stem cell clinics and how they are operating by working around the current laws in place. FDA does allow clinics to inject patients with their own stem cells, as long as cells meet certain criteria, but some of the treatments being advertised seem to flout FDA regulations.
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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Neurologists Share Tips for Securing Patient Access to Gene Therapies
March 19th 2025Tenacious efforts at every level, from the individual clinician to the hospital to the state to Congress, will be needed to make sure patients can access life-saving gene therapies for neuromuscular diseases.
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How Access to SMA Treatment Varies Globally and by Insurance Type
March 18th 2025Posters presented at the 2025 Muscular Dystrophy Association (MDA) Clinical & Scientific Conference show that therapeutic advances in treating spinal muscular atrophy (SMA) are not uniformly making it into the hands of patients who could benefit.
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Bustling Gene Therapy Pipeline for Neuromuscular Diseases Brings Thorny Questions to the Clinic
March 18th 2025The rapid development of gene therapy options for treating neuromuscular diseases has created new therapeutic options but also logistical hurdles and a need for complex discussions between clinicians and families.
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