New Opioid Bill Adds Requirements for Doctors
The Senate Health and Human Services committee has approved a bill that requires physicians to use the Prescription Drug Monitoring Program (PDMP). According to The Washington Times, the proposal squeezed by in a tight vote and will now go to the full Senate for a vote. The bill aims to identify and weed out physicians who overprescribe opioids and to prevent consumers from doctor shopping to gain access to opioids. Pharmacists have been required to participate in the PDMP for years, although enrollment for physicians had been voluntary.
12.2 Million People Sign Up for ACA Plans
Despite uncertainty surrounding the future of the Affordable Care Act (ACA) and the Trump administration’s decision to cancel last-minute ads, more than 12.2 million people signed up for coverage under the ACA. However, initial enrollment is still about 4% lower than last year. Nearly two-thirds of those who enrolled live in states that President Donald Trump carried. In Minnesota, a record number of people signed up through the state’s exchange. Although Minnesota had some of the sharpest premium increases for 2017, the state tapped a rainy day fund to help offset those rising premiums for people who weren’t eligible for federal subsidies.
Federal Government Ordered to Fund Risk Corridors
A Court of Federal Appeals has ruled in favor of an Oregon insurer, who sued the United States to recover money it was owed under the risk corridor program. The program protects insurers from excessive losses on the ACA exchanges. In a post for the Incidental Economist, Nicholas Bagley, JD, wrote that the ruling was the right one and that the court’s reasoning means every insurer can sue to recover risk corridor money. The government already owes $8.3 billion and the total liability could get close to $15 billion.
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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