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What We're Reading: Verma on Health Data; More Medicaid Work Requirements; NJ Individual Mandate
CMS Administrator Seema Verma announces a new health data initiative; Pennsylvania and Oklahoma consider implementing Medicaid work requirements; New Jersey moves forward with a state individual health insurance mandate.
CMS’ Verma Announces Health Data Initiative
At the annual conference of the Healthcare Information and Management Systems Society, better known as HIMSS, CMS Administrator Seema Verma announced that the Trump administration is working toward giving Americans greater access to their medical data. According to Bloomberg, the administration is still working on a timeline for the MyHealthEData initiative. Upcoming rules from CMS will also make it easier for patients to access records and for provider systems to talk to one another.
Pennsylvania and Oklahoma Consider Medicaid Work Requirements
Two more states may joining the growing number that implement work requirements in Medicaid. Pennsylvania is debating a requirement that able-bodied Medicaid recipients get work. The Inquirer reported that proposed legislation would cost the state $600 million to implement systems and supports if work is a requirement for Medicaid. In Oklahoma, the governor has ordered the state’s Medicaid agency to develop a work requirement. According to AP, Governor Mary Fallin suggested some exemptions, including children, pregnant women, the disabled, people caring for young children, and those seeking help in substance abuse programs.
New Jersey Moves to Require Health Insurance
The Trump administration ending the individual mandate enacted by the Affordable Care Act, but some states are considering implementing their own requirement to have insurance. A New Jersey state Senate panel has backed such legislation that requires residents to buy insurance or pay a fee. The bill was backed exclusively by Democrats. Those who opposed the bill worried it would place a financial burden on young adults.
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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