Thirty-nine states had contracts with comprehensive risk-based Medicaid managed care organizations and in 29 of those states, 75% or more of the Medicaid beneficiaries were enrolled in one of those organizations. A large majority (27 of 32) of the Medicaid expansion states used managed care organizations to cover newly eligibly adults.
A British study of 296,535 people added to evidence that the so-called obesity paradox—that being overweight or obese does not necessarily mean a greater chance of getting a heart attack—simply does not exist. Many of us could stand to lose a few pounds to lower our cardiovascular risk.
Despite standardization, advocates for various industries and certain patient needs continue to propose changes in coverage rules. Much of the advocacy is occurring at the state level with a focus on pharmaceutical coverage, such as equalizing cost sharing between oral and infused oncology drugs or setting limits on cost sharing for prescriptions.
Aimovig and other drugs targeting the CGRP neuropeptide aim to prevent migraines in a whole new way. But Aimovig’s cost may mean an obstacle course of prior authorization and step therapy.
The FDA’s work to redefine ‘truthful and non-misleading’ communication may preempt state efforts.
Health care is increasingly becoming like other retail encounters—a transaction between buyers and sellers. Patients, providers, payers—everybody needs to adjust. With the right technology and the will to change, the process of paying for health care can become as simple—and as painless—as getting a haircut.
Are we seeing the beginning of the end of the independent physician? Between July 2015 and July 2016, U.S. hospitals bought up 5,000 independent physician practices. In 2012, about 14% of practices were owned by hospitals. Four years later, that percentage had more than doubled to 29%.
Geisinger’s goal is to be not just one of the top health care organizations, but one of top organizations among all the companies in the United States.
Compared with control groups, the SGLT-2 inhibitors and GLP-1 agonists were associated with reductions in all-cause mortality—and researchers had set all-cause mortality as the primary outcome for the meta-analysis. As for the DPP-4 inhibitors, they identified an association with a small increase (0.1%) in all-cause mortality compared with controls.
Roughly one in 20 women of childbearing age suffer from major depression. Women without private health insurance had a 2.5-fold increased risk of major depression. The antidepressants most commonly used by women with major depression were selective serotonin reuptake inhibitors (21.3%), phenylpiperazines (8.4%), and serotonin-norepinephrine reuptake inhibitors (7.2%).
At first patients didn’t care that much. Then the monitors improved, and studies showed improved outcomes. But CMS wouldn’t cover them unless they had a ‘nonadjunctive’ indication. Now some envision a time when fingersticks will be a thing of the past for many people with diabetes.
There are four barriers to improving colorectal care for poor people. They are: limited resources, whether patients understand colorectal symptoms and physicians correctly diagnose them, beliefs about health and illness such as self-care, and patients’ reaction to illness.
Antibiotic resistance increases the cost of treating a bacterial infection by $1,383 and adds $2.2 billion to the country’s health care spending. Inpatient care is the biggest contributor to the incremental cost. Also costs related to antibiotic resistance were higher for older people and those in poor health.