May 14th 2024
A new study highlights significant disparity in reimbursement rates across states between hospitals and Medicare; the first patient to receive a genetically modified pig kidney has died; research examines outcomes of over 500 patients receiving medication abortion pills by mail.
CMS Releases Guidance on the Math Behind Part B, Part D Drug Rebates
February 10th 2023The Biden administration released 2 sets of guidance documents for pharmaceutical manufacturers about how it plans to implement the new Medicare Prescription Drug Inflation Rebate Program as required under the Inflation Reduction Act, and said some beneficiaries could see lower coinsurance for some Part B drugs as soon as April 1.
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Examining Trends in Outpatient Cancer Costs in Medicare During Last 6 Months of Life
February 7th 2023Drug costs, particularly for immunotherapies, contributed to the rising cost of care during the last 6 months of life for a fee-for-service Medicare beneficiary, according to a recent study.
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Dr Dennis Scanlon Discusses the Impact of the COVID-19 Pandemic on Medicaid Coverage
February 1st 2023With the public health emergency soon coming to an end, people covered by Medicaid will encounter new barriers, discusses Dennis Scanlon, PhD, professor of health policy and administration, Penn State University.
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IRA Insulin Cap Could Have Saved Medicare Beneficiaries Millions in 2020
January 30th 2023An HHS report said that if the Inflation Reduction Act (IRA) had been implemented in 2020, Medicare Part D beneficiaries could have saved a total of $734 million, averaging out to about $500 per member.
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Adding Social Factors to Risk Adjustment Not Enough to Reach Health Equity, Paper Says
January 12th 2023To best improve health equity, population-based payment models should both incorporate social goals and increase payment for historically marginalized communities, a recent study has found.
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Dr Ken Cohen Offers Possible Solutions to Reducing Wasteful Health Care
January 12th 2023Creating new incentive models and transparently sharing data in a way that changes behaviors are 2 ways to reduce low-value care in the health care system, explains Ken Cohen, MD, director of translational research for Optum Care.
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Associations Between Physician Practice Models and Health Information Exchange
January 11th 2023A survey of all Arizona physicians found that accountable care organization, clinically integrated network, or integrated delivery network participation was associated with higher use of health information exchange. However, there are exceptions and important barriers noted.
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Allina Health’s Mike Koroscik on Helping Patients Navigate Cancer-Related Financial Toxicity
January 6th 2023We want to make it easy for our patients to manage and navigate the financial toxicity they encounter from their cancer care, noted Mike Koroscik, MBA, MHA, vice president of oncology, Allina Health and the Allina Health Cancer Institute.
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Top 5 Most-Viewed Reimbursement Content in 2022
December 30th 2022The top 5 pieces of content published on AJMC.com relating to reimbursement issues included 2 on the significance of a California law giving Medicare beneficiaries access to expert oncology care; other articles looked at the work involved in value-based care models and CMS news.
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Dr Vineet Arora: Balancing Reimbursement Incentives With What Matters to Clinicians
December 18th 2022Our current health care reimbursement system rewards procedures and undervalues the time spent talking with patients and learning their history, which speaks to the need for primary care redesign, according to Vineet Arora, MD, MAPP, dean for medical education at UChicago Medicine.
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Organizational Capacity Among Hospitals in Medicare and Commercial Bundled Payments
A national survey demonstrated differences in organizational capacity between hospitals participating in Medicare bundled payment programs and those coparticipating in both Medicare and commercial bundled payment programs.
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HDHPs Deter Women From Additional Testing After Abnormal Mammogram, Study Says
November 29th 2022The groups who told researchers they would be more likely to skip additional testing had lower levels of income or education and were more likely to be on Medicaid or be uninsured, among other factors.
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