Drug Price Transparency in Medicare
Senators have reintroduced a bill to improve drug pricing transparency in Medicare and provide more accurate information online. According to The Register-Herald Reporter, the bill would also prohibit Part D plans and pharmacy benefit managers from retroactively reducing payments on accurate reimbursement claims from pharmacies. The legislation was previously introduced in the 114th Congress and is being reintroduced by Senators Shelley Moore Capito, R-West Virginia, and Jon Tester, D-Montana.
Divisions in GOP May Derail ACA Repeal, Tax Reform
Just before Congress left for a recess, Senate Majority Leader Mitch McConnell, R-Kentucky, said he doesn’t expect Republicans will have help from Democrats when it comes to repealing the Affordable Care Act (ACA). While Democrats do not have the numbers to stop a repeal and replace of the ACA, they may not need to, reported the Associated Press. Divisions within the Republican Party may threaten the repeal of the ACA and an overhaul of the tax code as there is disagreement on how to move forward on both issues. Republicans have already missed the initial January 27 deadline to replace the ACA, but the Trump administration is still expecting a plan to replace the ACA within a few weeks.
Drug Theft Occurring at VA Health Facilities
An analysis of government data has shown increasing incidents of drug loss or theft at facilities within the Department of Veterans Affairs (VA) health system. Associated Press reported that the number of these incidents increased nearly tenfold since 2009. The article highlights instances of VA employees diverting painkillers to sell on the street or for their own use.
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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