Humana to Pull Out of 2018 Exchanges
Shortly after calling off its proposed merger with Aetna, Humana announced it would not participate in the Affordable Care Act exchanges in 2018. After analyzing membership data from the 2017 open enrollment period, “Humana is seeing further signs of an unbalanced risk pool,” the insurer stated in a press release explaining the decision. In a tweet, President Donald Trump seized the news as an example of how “Obamacare continues to fail.”
Polypharmacy On the Rise in Elderly Patients
A study recently published in JAMA Internal Medicine points to a concerning trend of physicians prescribing 3 or more central nervous system (CNS) drugs at once for elderly patients. CNS polypharmacy among those aged 65 or older has more than doubled between 2004 and 2013, partially driven by an increase in prescribing among patients with a pain diagnosis. The largest increase in CNS polypharmacy was among rural visits, “where access to specialty mental health or pain care is particularly limited,” the authors wrote.
Pharma Executives Keep Wary Eye on FDA's Future
President Trump’s calls to slash government regulations and speed up the FDA’s drug approval processes have put some pharmaceutical industry leaders on edge, according to a Reuters article. Over a dozen drug and biotechnology firms have implored the new administration not to implement a too-hasty approval process, worrying that insurers will refuse to pay for a new drug if its safety is not thoroughly proven. "It is one thing to get a drug approved, but you have got to get reimbursed," said Paul Perreault, chief executive of biotech company CSL Ltd, in the article.
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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Integrated CKD Care Model Cuts ED Visits by 30%, Boosts Specialized Treatment
April 21st 2025An analysis of an interdisciplinary care model for managing chronic kidney disease (CKD) shows hospital admissions dropped by 26% and emergency department (ED) visits decreased by 30% after clinic initiation.
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