Managed Care News and Research

RSS

First Edition: October 5, 2012

Now on the blog, Phil Galewitz reports on what one expert describes as the "challenges" related to explaining the health law: "More than two and a half years after he signed the most far reaching health care legislation into law, President Barack Obama showed in his Wednesday debate with Mitt Romney that explaining the law is still no easy job."

5 Oct 2012

Roundup: Mass. health plans lauded for comprehensiveness; Doctors question efforts like Calif.'s law on nurse practitioners

Health insurance plans offered in Massachusetts and analyzed by U.S. News & World Report were found to be among the most comprehensive in the country. The analysis included 67 plans from four Massachusetts insurers that are sold to individuals or families. Each earned at least four of five stars based on scope of coverage and cost to consumers. In other states, the portion of plans with the higher rankings ranged from 4 percent in Washington to 94 percent in New York.

5 Oct 2012

Medicaid: Ariz. expansion savings detailed; Kan. prepares for managed care approval

In Medicaid news, a report details how an expansion there would save Arizona money. And a Kansas official says a planned move of recipients to managed care is likely to be approved by federal authorities.

28 Sep 2012

Roundup: Calif. mental hospitals released from fed oversight; Kansas hospitals cooperate to recruit rural docs; Va. abortion law questions

A U.S. District Court judge Monday released the state's mental hospitals from federal oversight on all but one issue -- a significant step in ending a costly six-year reform effort. The extensive court-supervised changes were imposed on four hospitals in 2006 as part of a settlement to a lawsuit by the U.S. Department of Justice. The department alleged that the state was violating patients' civil rights by heavily drugging and improperly restraining them and failing to provide appropriate treatment.

26 Sep 2012

Cancer-related medical costs to more than double in some states in less than eight years

Cancer-related medical costs, already a significant portion of overall medical expenses in the United States, will more than double in some states in less than eight years, according to a new study by researchers from RTI International and the Centers for Disease Control and Prevention.

25 Sep 2012

Viewpoints: How media missed Ryan AARP story; Romney and women voters; The price of medical mistakes

The headlines this weekend were all about the boos Paul Ryan elicited on Friday when he addressed the AARP, the self-styled seniors' lobby. The herd of independent media minds missed the real story, which is that the Republican Vice Presidential nominee went into the heart of the entitlement culture, told some hard truths, and even won applause for doing so.

25 Sep 2012

Layoffs hit group health in Washington and Boston Children's Hospital

Group Health Cooperative, recognized as a leader in health-care innovations and patient satisfaction, says it must cut $250 million over the next 16 months through layoffs, better cost control and some reorganization at the top. As part of those changes, Richard Magnuson, executive vice president and chief financial and administrative officer, will soon leave the organization.

21 Sep 2012

FDA approves Acton’s AEROSPAN sNDA to treat asthma

Acton Pharmaceuticals, Inc. announced today that the U.S. Food and Drug Administration (FDA) has approved the sNDA (Supplemental New Drug Application) for AEROSPAN (flunisolide HFA, 80 mcg) Inhalation Aerosol, a hydrofluoroalkane (HFA) orally inhaled corticosteroid indicated for the maintenance treatment of asthma as a prophylactic therapy in adult and pediatric patients 6 years of age and older.

21 Sep 2012

Small subset of patients with OAG accounts for large proportion of all glaucoma-related charges

A small subset of patients with open-angle glaucoma (OAG) account for a large proportion of all glaucoma-related charges in the United States, according to new data published by researchers at the University of Michigan Kellogg Eye Center and Washington University, St. Louis.

20 Sep 2012

Roundup: Filipino nurses in Calif. win $1M in language discrimination lawsuit; Texas Lawmakers hear of Medicaid managed care woes; Calif. soda limits could be next

A group of Filipino nurses who claimed they were mocked for their accents and ordered to speak "English only" won a nearly $1-million settlement against a Central California hospital where bosses and co-workers were allegedly urged to eavesdrop on the immigrant workers.

19 Sep 2012

Roundup: Mont. settlement money to pay for uninsured's prescription drugs; Physician assistants' role in Mass.; Atlanta to cut worker premiums

The Montana attorney general's office says nearly $1 million collected in drug company settlements will be used to help pay for prescription medicine for people who are uninsured and underinsured. Attorney General Steve Bullock said in a statement Thursday the money came from settlements dating back to 2010 with four drug companies accused of inflating the wholesale prices of drugs paid by Medicare and Medicaid.

18 Sep 2012

Health Net sued over 'medically unnecessary' coverage denials

Some Californians are suing Health Net over the insurer's refusal to cover some treatments after it deemed them medically unnecessary.

15 Sep 2012

New efforts to improve Medicaid in California, Colorado

Advocates caution that California's ambitious program for dual eligibles could be problematic, while Colorado's effort to move Medicaid patients into medical homes is showing savings.

14 Sep 2012

Roundup: Mich. Gov. proposes making BCBS a tax-paying insurer; Merger creates one of largest hospitals in Conn.; W. Va. chiropractor board scrutinized

Blue Cross Blue Shield of Michigan would no longer be exempt from about $100 million a year in state and local taxes but would be subject to more streamlined and speedier rate reviews and approvals under legislation proposed today by Gov. Rick Snyder. The nonprofit health insurer would also pay $1.5 billion over 18 years into a separate nonprofit aimed at tackling issues such as obesity and infant mortality to improve the health of all Michigan residents, Snyder said at a news conference.

13 Sep 2012

In Florida, Obama talks Medicare

President Barack Obama promised to fight GOP efforts to "privatize" the health insurance program for senior citizens, charging that the plan advanced by Republican nominee Mitt Romney would cost seniors more.

11 Sep 2012

Viewpoints: Home health workers need better pay; Is there a better solution than Medicaid to cover seniors' long-term care?

[F]or the stay-at-home elderly to have so-called "independent living" they must be highly dependent on the home care aides who look after medication schedules, cook meals, assist with bathing and generally keep them happy and healthy. And yet these workers are anything but well cared for. The vast majority are dreadfully overworked and woefully underpaid. The average hourly wage of a home care worker in the United States is less than $10.

11 Sep 2012

Maine sues CMS seeking Medicaid cuts resolution

Maine -- unhappy with how long a decision is taking -- is suing the federal government over its request to lower Medicaid eligibility.

6 Sep 2012

Roundup: Cancer drug cost equity bill sitting on Calif. Gov's desk; Mass. cost-containment law could harm provider credit ratings

Out-of-pocket costs for cancer drugs can vary dramatically depending on whether the medications are administered through pill form or intravenous infusion. Newer oral drugs, which can be taken at home and often have fewer side effects than older drugs, can cost patients thousands of dollars a month, while receiving chemotherapy through an IV in an infusion center typically amounts to a standard co-payment for an office visit.

6 Sep 2012

Roundup: Texas probes Xerox in Medicaid overbilling; Miss. abortion clinic fights to stay open

Texas authorities are investigating whether Xerox Corp. played a role in allowing dentists to allegedly overbill the state's Medicaid system by millions of dollars.

5 Sep 2012

Ga. Gov. signals willingness to discuss Medicaid expansion compromise

After the Georgia governor seemed to rule out Medicaid expansion in a convention speech, a spokesman qualified that it might change if the state had options not now on the table.

31 Aug 2012