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What We're Reading: Government Doesn't Owe Insurers ACA Money; Hep A Outbreak; Risky Teen Behaviors
The federal government does not have to pay insurers money as part of an Affordable Care Act (ACA) program that enticed them to participate in the markets; there is a hepatitis A outbreak among drug users and the homeless occurring in 6 states; teenagers in the United States are not only exhibiting less risky behaviors, such as smoking and doing drugs, but they are also drinking less milk.
Court Rules Government Doesn’t Owe Insurers Money
The federal government does not have to pay insurers money as part of an Affordable Care Act (ACA) program that enticed them to participate in the markets. A federal appeals court ruled the insurers are not owed the more than $8 billion they claimed as part of the ACA’s “risk corridors” mechanism, reported The Wall Street Journal. The program was put in place to encourage insurer participation by helping to cover their financial risks. Insurers have filed approximately 2 dozen lawsuits on the issue.
Hepatitis A Outbreak in 6 States
There is a hepatitis A outbreak among drug users and the homeless occurring in 6 states: California, Indiana, Kentucky, Michigan, Utah, and West Virginia. According to The Hill, the CDC has received more than 2500 reports of hepatitis A infections in the states from January 2017 to April 2018. Hepatitis A can be prevented with a vaccine, and there have not been any large outbreaks of hepatitis A infection in the United States among drug users since 1996. No outbreaks among the homeless population have ever happened in the United States.
Survey Shows Teens Engage in Less Risky Behaviors
Teenagers in the United States are not only exhibiting less risky behaviors, such as smoking and doing drugs, but they are also drinking less milk. STAT reported that researchers compared the results of a survey on a wide range of health topics to similar questionnaires going back more than 25 years. Milk consumption started dropping after World War II, and kids are shifting from drinking milk to more energy drinks. The survey also found fewer teens are having sex—40% said they had had sex compared with 48% a decade ago.
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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