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What We're Reading: Insurer Profits in 2019; Drug Pricing Proposal; Medical Record Errors
The 2019 outlook for health insurers in the United States looks stable; Senator Bernie Sanders, I-Vermont, and Representative Ro Khanna, D-California, have released a bill that takes cues from President Donald Trump’s proposal to reduce Medicare drug costs through the use of an international pricing index; older Americans should be aware of what is in their medical records and whether the data are accurate.
Moody’s Has Positive Outlook for Insurers in 2019
Moody’s Investor Services has announced that the 2019 outlook for health insurers in the United States looks stable. According to the credit ratings agency, the stable outlook can be attributed to things like insurers adjusting to the Affordable Care Act and achieving profits in these marketplace plans. While Moody’s expects vertical integration will continue in 2019, it expects these efforts to continue on a smaller scale.
New Bill Takes Cue From Trump’s Drug Pricing Proposal
Senator Bernie Sanders, I-Vermont, and Representative Ro Khanna, D-California, have released a bill that takes cues from President Donald Trump’s proposal to reduce Medicare drug costs through the use of an international pricing index. Politico reported that the bill would also tie US drug costs to international prices, although Trump’s proposal is narrower and only applies to Medicare Part B. Under Sanders and Khanna’s bill, drug companies would be incentivized to charge prices similar to those in other countries, and if they do not, the government could intervene to allow generic competition.
Checking Medical Records for Errors
Older Americans should be aware of what is in their medical records and whether the data are accurate. It is estimated that nearly 10% of people who access their records online end up requesting corrections to it. Kaiser Health News dived into the accuracy of medical records and the difficulties that can occur if an incorrect diagnosis or test result ends up in a record, which can result in inappropriate treatment. However, additions aren’t the only concern—omissions from records can also wreak havoc.
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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