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What We're Reading: Puerto Rico Dilemma; Reporting Superbug Deaths; VA Accountability
Fight Over Funding Medicaid in Puerto Rico
With Puerto Rico on the verge of bankruptcy, lawmakers are divided how much more Medicaid money to send to the island. According to The Wall Street Journal, the territory is set to finish off its $6.4 billion Medicaid grant by the end of 2017. Puerto Rico has to complete renewal contracts with managed care organizations, but this task is complicated by the lack of replacement funding.
Removing a Requirement to Report on Superbug Deaths
A California bill that included a measure requiring hospitals to report drug-resistant bacterial infections on death certificates has drawn strong opposition. The Los Angeles Times reported that the measure has been removed from the bill after the California Hospital Association and the California Medical Association vocally opposed the plan. The bill would have required an annual report on these deaths, but the name of the hospitals would not have been revealed.
Improving Accountability in the VA
President Donald Trump has created a new office at the Department of Veterans Affairs that would improve accountability. The new Office of Accountability and Whistleblower Protection would also protect whistleblowers from retaliation and help identify ways to discipline or fire employees for poor performance, reported The Washington Post. Last week, Trump signed a bill to extend a program allowing veterans to seek private care.
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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