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What We're Reading: OxyContin Coverage; Puerto Rico's Medicaid Funds; Hepatitis Outbreak Continues
Cigna Will End Coverage of OxyContin
As insurers, providers, and lawmakers try to find a way to combat the growing opioid addiction epidemic, Cigna is taking its own steps to stop covering OxyContin. According to Reuters, the insurer will replace OxyContin with an equivalent that is less vulnerable to abuse. The formulation of Xtampza ER prevents it from being more fast-acting through cutting or crushing, and under the contract with Cigna, the drug maker will lower the cost of the medication for many plans. Some individuals using OxyContin will continue to be covered in 2018, but others are being notified of the upcoming switch.
Puerto Rico’s Medicaid Funding Attracts Attention
The devastation left behind on Puerto Rico after Hurricane Maria has brought attention to another issue on the island: Medicaid funding. Nearly half of all Puerto Ricans are on Medicaid, but the island does not receive as much government money as the states, reported The Washington Post in The Health 202. Without additional funding, the program is expected to run out of money by the start of 2018, if not sooner. Currently, the federal government funds far less of the island’s Medicaid program compared with states, but Democrats are now calling to lift the cap on Puerto Rico’s Medicaid funding.
San Diego Hepatitis Outbreak Grows
The hepatitis A outbreak in San Diego County has not slowed down. The number of confirmed cases is now 481 with 337 hospitalizations; however, the death count has not risen in the past 2 weeks, according to the Los Angeles Times. For the last 2 weeks, more than 40 cases have been under investigation. Most of the deaths have been people who had other underlying medical conditions, and most people affected were homeless or drug users. Public health officials are continuing to administer vaccinations to those at the highest risk, including people who work with homeless individuals, health and safety workers, and food service workers.
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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