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Enrollment in managed Medicaid plans on the rise

Tough economic times are driving people both in and out of Medicaid programs. Medicaid enrollment climbs as individuals deal with loss of insurance through employment channels. Then, state legislators challenged with making budget cuts, are forced to reduce Medicaid rosters to balance budgets. Many states are increasing their use of care management strategies to help rein in costly Medicaid programs.

22 Apr 2011

Decision Resources: 63% of neurologists select Tysabri as effective MS treatment

Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that the majority of surveyed U.S. neurologists selected Biogen Idec/Elan's Tysabri as the most effective therapy for the treatment of relapsing-remitting multiple sclerosis, when compared to other currently available agents.

22 Apr 2011

Meridian Bioscience second quarter net sales increases 32% to $41.1 million

Meridian Bioscience, Inc., today reported fiscal 2011 second quarter and six months net sales of $41.1 million and $78.3 million, respectively, increases of 32% and 6%, respectively, from the same periods of the prior fiscal year;

21 Apr 2011

State roundup: Michigan tries new strategy on high risk pools

Michigan today announced a new effort to sign up the chronically uninsured onto health plans after the state's first attempt did not attract enough customers.

20 Apr 2011

Pharmacy costs for multiple sclerosis patients increase at a faster rate than medical costs

Analysis of direct pharmacy and medical costs for patients with multiple sclerosis (MS) showed pharmacy costs are increasing at a slightly faster rate than medical costs, but new MS medications are expected to shift the majority of the direct health cost burden to pharmacy, according to a new study by Prime Therapeutics (Prime). The study will be presented at the Academy of Managed Care Pharmacy's 23rd Annual Meeting in Minneapolis, Minn.

15 Apr 2011

Calif. joins suit against Sutter Health, alleges fraud charges for anesthesia

Sutter Health, one of California's largest health care givers, fraudulently charged insurers up to hundreds of millions of dollars over the past decade for anesthesia services that in some cases weren't even provided, the state's insurance commissioner said Wednesday (Allday, 4/14).

15 Apr 2011

State roundup: Pa. may put half of adultBasic members on Medicaid

Regulators in charge of the Massachusetts health insurance law are expected to approve new contracts today that will save the state $80 million, in part by offering a narrower choice of hospitals, physicians, and specialists to thousands of patients insured through the state-subsidized Commonwealth Care program.

15 Apr 2011

Medicaid news: Govs split on block grants; Kansas begins 'makeover'

Even as states try to move forward with a Medicaid makeovers, transforming this state-federal program into a block grant comes with complications.

12 Apr 2011

Depression can sabotage efforts to effectively treat Hepatitis C

Adherence to interferon, an important medication used to treat Hepatitis C, is critical to successfully clearing the virus that causes the disease. A new observational analysis by Medco Health Solutions, Inc. finds that when Hepatitis C patients are also being treated for depression -- a frequent side effect of interferon use -- they are more likely to remain on their interferon therapy.

12 Apr 2011

State News: N.Y. billing for disabled patients questioned

While the nation's attention has been focused on state worker battles in union strongholds such as Ohio and Wisconsin, quiet but consequential labor battles are breaking out in Kansas, Texas and other states where collective bargaining rights for public workers were weak or non-existent to begin with. The outcome of these confrontations will have a big impact.

8 Apr 2011

NEJM: Perspectives from Aaron, Reinhardt, Iglehart, Annas, Chambers and others

This week's New England Journal of Medicine features perspectives from prominent authors on Medicare and Medicaid. NEJM granted KHN permission to excerpt substantial portions of these columns.

8 Apr 2011

Roundup: Minn. approves deep health spending cuts; Mass. voters say state health law not working

In a pioneering bid to streamline the state's big health insurance programs, the Legislature's new Republican majority is poised to give thousands of low-income Minnesotans vouchers to buy coverage in the private marketplace.

8 Apr 2011

Roundup: Minn. insurers to return profits above 1% from state plans; Fla. Medicaid managed care costs questioned

In part of the continuing change to Minnesota's business with health insurance plans, the state announced Tuesday that four major health plans agreed to a 1 percent cap on their profits on state business. The one-cap means that the plans -- BlueCross BlueShield, HealthPartners, Medica, and UCare -- will return any profit above 1 percent to the state next April.

7 Apr 2011

State roundup: Report urges Mass. city employees to pay more health costs

Officially, Minnesota doesn't pay for an intensive type of autism therapy. Yet it has -- but only for some families. Two years ago, a single mother in the Twin Cities asked the state Medicaid program to pay for an intensive type of autism therapy for her 2-year-old son. She was turned down. State officials said the treatment -- known as Applied Behavior Analysis, or ABA -- is "not now, and never has been,'' a covered service.

6 Apr 2011

Milliman Care Guidelines presents Doyle Award to ADVANTAGE Health Solutions and Sound Physicians

Milliman Care Guidelines today presented its Doyle Award for Innovation and Leadership in Healthcare to ADVANTAGE Health Solutions, Inc.(SM) and to Sound Physicians. The awards were presented in ceremonies here at the Milliman Care Guidelines Client Forum.

5 Apr 2011

Ectopic pregnancies on the rise

Ectopic - or tubal - pregnancies can be dangerous for mothers, leading to rupture of the fallopian tube and possible hemorrhage, and they appear to be on the rise, according to a new study.

5 Apr 2011

Long-awaited federal rule for accountable care organizations outlines 'gains and risks' for doctors, hospitals

Health and Human Services Secretary Kathleen Sebelius and Centers for Medicare and Medicaid Services Administrator Donald Berwick announced the release of the proposed rule Thursday, offering insights into how the administration hopes to encourage doctors and hospitals to collaborate more closely to improve patient care.

2 Apr 2011

Minnesota medical spending reached $17.4 billion in 2010

Health costs per person in Minnesota rose only 2.6 percent in 2010, about half the national average. Key factors in controlling costs were innovations by Minnesota's health plans – for example, more effective management of care for those with chronic diseases – and reduced demand for health care in a slow economy.

2 Apr 2011

Roundup: Fla. moves closer to Medicaid overhaul; Abortion provisions advance in Va., Kan. and Iowa

The Florida House on Thursday approved a statewide proposal to shift Medicaid beneficiaries into managed-care plans. ... Supporters said the plan would improve care for Medicaid beneficiaries, reduce widespread fraud and control costs in the $20 billion program.

1 Apr 2011

Research roundup: Patient's income and electronic health records; high deductible plans; raising Medicare age

Healthcare Spending And Preventive Care In High-Deductible And Consumer-Directed Health Plans - Authors analyzed data from more than 800,000 families insured during 2004 and 2005 through one of 53 large employers in U.S., about half offering the high-deductible or consumer-directed plans.

1 Apr 2011

Managed Care News and Research

Enrollment in managed Medicaid plans on the rise

Decision Resources: 63% of neurologists select Tysabri as effective MS treatment

Meridian Bioscience second quarter net sales increases 32% to $41.1 million

State roundup: Michigan tries new strategy on high risk pools

Pharmacy costs for multiple sclerosis patients increase at a faster rate than medical costs

Calif. joins suit against Sutter Health, alleges fraud charges for anesthesia

State roundup: Pa. may put half of adultBasic members on Medicaid

Medicaid news: Govs split on block grants; Kansas begins 'makeover'

Depression can sabotage efforts to effectively treat Hepatitis C

State News: N.Y. billing for disabled patients questioned

NEJM: Perspectives from Aaron, Reinhardt, Iglehart, Annas, Chambers and others

Roundup: Minn. approves deep health spending cuts; Mass. voters say state health law not working

Roundup: Minn. insurers to return profits above 1% from state plans; Fla. Medicaid managed care costs questioned

State roundup: Report urges Mass. city employees to pay more health costs

Milliman Care Guidelines presents Doyle Award to ADVANTAGE Health Solutions and Sound Physicians

Ectopic pregnancies on the rise

Long-awaited federal rule for accountable care organizations outlines 'gains and risks' for doctors, hospitals

Minnesota medical spending reached $17.4 billion in 2010

Roundup: Fla. moves closer to Medicaid overhaul; Abortion provisions advance in Va., Kan. and Iowa

Research roundup: Patient's income and electronic health records; high deductible plans; raising Medicare age

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