CMS proposed new protections for Medicare beneficiaries in Medicare Advantage and prescription drug plans by providing more regulation on door-to-door marketing and cold-calling, as well as new proposed requirements pertaining to broker/agent commissions. The proposal goes beyond what the health care insurance industry recently endorsed as necessary regulatory changes to the program for development. “This is an important step to ensure beneficiaries can rely on information being provided to make Medicare coverage decisions that are right for them,” says Karen Ignagni, president and CEO of America’s Health Insurance Plans (AHIP). AHIP is reviewing the new regulations and is developing detailed comments… The age of a business may affect a manager’s decision to offer health benefits, according to a new report from the Henry J. Kaiser Family Foundation. The report suggests that for smaller and mid-sized establishments, the likelihood of offering coverage is positively associated with the age of the business. Insurers may want to give special focus to the issues faced by small businesses just starting up or in the early years of operation. Special subsidies or products for these businesses may be needed to encourage these businesses to purchase, and their workers to enroll in, health plans. The analysis is based on data from the insurance component of the Medical Expenditure Panel Survey… A recent study published in the British Medical Journal suggests that blood glucose self-monitoring is not cost-effective. In a randomized, controlled trial, 184 people with newly diagnosed type 2 diabetes were placed in either a self-monitoring group or in a control group that did no self-monitoring. Researchers found no significant difference in HbA1c, body mass index, or use of oral hypoglycemic drugs. However, patients in the self-monitoring group had higher on depression in the study’s well-being questionnaire.
FiercePharma has compiled a list of the top 15 cancer medications that are expected to dominate the oncology market in 2022.
Joint venture plans are starting to demonstrate their ability to implement clinical management and financial management reforms. A JV health plan replaces the offloading of financial risk by health plans to ill-equipped providers with an executive-level cost management committee stated jointly by the hospital and payer.
For several days, a middle-aged woman who claimed to be a doctor in training roamed the halls of Brigham and Women’s Hospital in Boston, dressed in scrubs, asking questions at a lecture, attending patient rounds, and observing surgical procedures, according to a report in the Boston Globe