Early sign-ups are strong under ACA; new food safety rules become final; report finds poor access to HIV drugs.
CMS Reports 543,098 Select Plans Through Federal Marketplace
More than half a million consumers selected health coverage during the first week of open enrollment for 2016, according to data released yesterday by CMS.
This is the third year Americans can use healthcare.gov or state exchanges to sign up for coverage under the Affordable Care Act. CMS is providing weekly data on how many consumers are filling out applications, shopping for insurance online, waiting for assistance from the call center, or purchasing insurance. For more information, see here.
Most States Offer Limited Coverage for HIV Drugs Under ACA
A new survey from Avalere reports that 16% of the silver exchange plans covered all the top HIV drugs for $100 or less each in 2015. The report found that nearly half the plans include the top 10 most commonly prescribed HIV regimens in their plans, but many charge high out-of-pocket premiums.
Major health plans have been taken to court over access to HIV medications. The AIDS Institute and the National Health Law Program filed a complaint with Florida’s civil rights office over policies by Cigna, Humana, Preferred Medical and CoventryOne which the advocates said were designed to steer HIV/AIDS patients from applying for their prescription plans. Florida insurance officials eventually reached agreements with the insurers. For more, see here.
FDA Finalizes Groundbreaking Food Safety Rules
Rules to implement the bipartisan Food Safety Modernization Act became final today. For the first time, the nation has enforceable standards for produce farms and can make importers accountable that food brought into the United States meets this country’s safety standards. The rules establish a third-party accreditation program of auditors to help enforce the rules, which come in response to high-profile outbreaks of illness in foods from peanut products to spinach. For more, read here.
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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