Insurers Reluctant to Cover Costly but Lower-Risk Painkiller Alternatives
Although there are opioid and non-opioid painkillers available that lessen the risk of abuse, a new investigation finds that these costlier drugs are often not covered by insurers. The report published by the New York Times and ProPublica featured interviews with patients who were denied access to less-risky opioids, like buprenorphine patches, or non-opioid alternatives by their insurers, who were more likely to cover opioids like morphine that have a higher potential for abuse and addiction. The article also raised concerns about limited insurer coverage of addiction treatments.
After Heat Deaths, Florida Nursing Home Ejected from Medicaid Program
After Hurricane Irma’s power outages led to the deaths of 8 residents in a Florida nursing home who were exposed to excessive heat, the state is taking measures like suspending the facility from participating in Medicaid. Reuters reported that the state’s health agency also prohibited the Rehabilitation Center at Hollywood Hills from accepting new patients, and the building has been sealed by police after all residents were evacuated. State and federal authorities have begun conducting a criminal investigation into the loss of life that occurred at the facility.
Patients With Sickle Cell Disease Face Uphill Battle for Adequate Care
A new report published by STAT revealed the unmet care needs among patients with sickle cell disease, who can face delays in emergency treatment, biased judgments, and inadequate primary care. The 12 patients interviewed in the article said that clinicians often consider them drug-seekers due to their race, as the painful condition predominantly affects African Americans. They also described how many primary care physicians are not equipped to manage the condition, which leads to patients seeking treatment in the emergency department when they experience an episode, although they do not always receive appropriate care from emergency clinicians.
AI in Health Care: Balancing Governance, Innovation, and Trust
September 2nd 2025In this conversation with Reuben Daniel, associate vice president of artificial intelligence at UPMC Health Plan, we dive into how UPMC Health Plan builds trust with providers and members, discuss challenges of scaling AI effectively, and hear about concrete examples of AI's positive impact.
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Team Coordination, Data Sharing Help Prioritize Value in Cardio-Renal-Metabolic Care
September 12th 2025Cardiologists, nephrologists, and payers met in Scottsdale, Arizona, on August 26, 2025, to share insights on how team members can work together, empowered by data, to achieve value-based management of cardio-renal-metabolic syndrome.
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