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What We're Reading: Patchwork Health Insurance; Transforming Medicaid; EpiPen Shortage
Facing ever-increasing costs, some families are forgoing traditional medical insurance in favor of patching together an alternative using multiple sources; a new initiative led by former CMS Administrator Andy Slavitt is looking to transform Medicaid with actionable solutions to address the health and social determinants of vulnerable populations; before kids go back to school, sales of the EpiPen usually spike, but this year parents are scrambling to find the injector.
Consumers Patch Together Health Insurance
Facing ever-increasing costs, some families are forgoing traditional medical insurance in favor of patching together an alternative using multiple sources. Bloomberg News is outlining the lengths people will go to as they struggle to afford healthcare. The article highlights the decisions one family made that included joining a primary care clinic that charged a monthly fee and a healthcare sharing ministry, a religion-based cost-sharing plan. The number of people with traditional insurance is expected to decrease now that the Trump administration has dismantled certain aspects of the Affordable Care Act, such as the individual mandate.
Health Systems Join Forces to Transform Medicaid
A new initiative led by former CMS Administrator Andy Slavitt is looking to transform Medicaid with actionable solutions to address the health and social determinants of vulnerable populations. A total of 17 health systems, representing 5% of the nation’s hospitals, have joined the Medicaid Transformation Project. The project will focus on behavioral health, care for women and infants, substance use disorder, and avoidable emergency department visits. A core team at each health system will implement solutions, and all participants will share best practices across the network.
Parents Search for EpiPens Before School Starts
Before kids go back to school, sales of the EpiPen usually spike, but this year parents are scrambling to find the injector. Manufacturing issues and supply disruptions have caused a shortage of EpiPens, but there may still be ways to find the EpiPen, according to USA Today. Parents can call Mylan’s customers relations, which has extended hours to help locate pharmacies with the EpiPen. The FDA is also trying to alleviate the situation by extending expiration dates of certain lots by 4 months. In the future, shortages may not be as much of an issue now that the FDA has approved a generic version.
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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