Some Immigrants in California Cancel Health Insurance
In California, legal immigrants are not enrolling in Medi-Cal or are canceling coverage in the wake of the Trump administration’s approach to immigrants, reported California Healthline. Legal immigrants are concerned that enrolling in Medi-Cal may put family members who do not have legal status in danger of being deported. In addition, some worry that they may be penalized for using public benefits even though they are legally eligible for these benefits. However, immigration experts note that canceling coverage may not help—their names are already in the system.
ACA Repeal and Replace May Affect Employer-Sponsored Insurance Tax Breaks
As Republicans work on a plan to replace the Affordable Care Act (ACA), they need to find a way to offset the costs of providing tax credits for individuals. One potential plan is to cap how much of employer health benefits can be protected from taxes. The health insurance benefit that employees receive from employers currently isn't taxed, but the new plan could limit how much is tax free. Health plans that exceed the limit on the value of these benefits would be subject to income tax on the amount the difference. Democrats worry that this strategy could mean employers offer less generous plans.
Cigna and Anthem’s Merger Saga Continues
A judge has temporarily blocked Cigna’s attempt to immediately terminate its proposed merger from Anthem, The Wall Street Journal reported. After a judge blocked the merger between Anthem and Cigna, Cigna sought to terminate the merger, plus sued Anthem for $13 billion in damages. Anthem filed its own lawsuit to prevent Cigna from immediately ending the deal, and is trying to appeal the ruling that blocked the merger. The merger has been contentious between the 2 companies, with both accusing the other of violating the deal.
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