Managed Care News and Research

RSS

States anxiously hoping for extra Medicaid funds extension

Kaiser Health News: "Democrats are leaving Washington for their July 4th recess without passing key parts of their health agenda. Among the provisions being left for when Congress returns from a week-long break: enhanced Medicaid aid for states and a subsidy to help the laid off afford to keep their former employer's health insurance.

3 Jul 2010

CED report warns that health care reform will not succeed without cost reforms

The health-care delivery system and payment structure need significant reforms, or the health care reform law passed by Congress will prove to be an "empty promise." That is the conclusion of a new report, Health Care in California and National Health Reform, from the business-led Committee for Economic Development.

1 Jul 2010

Lawmakers urge swifter launch of home health care demo

"The so-called Independence at Home (IAH) program, included as part of the Democrats' new health reform law, is scheduled to take effect no later than Jan. 1, 2012, but Sen. Ron Wyden (D-Ore.) and Rep. Edward Markey (D-Mass.) warn that waiting that long would threaten the health of one of the country's most vulnerable populations," The Hill reports.

1 Jul 2010

Counseling programs increase mammography compliance among low-income women

Even with health insurance, low-income women had lower rates of mammography screening than middle-class women, but a counseling program increased the likelihood of screening.

30 Jun 2010

WellPoint research leads to limits on use of Boniva; FDA spars with tobacco company

"WellPoint Inc. (WLP), the largest U.S. managed-care concern by membership, made it harder last year for its members to gain approval for use of the Boniva osteoporosis drug after internal research linked it to higher fracture rates, lower patient compliance and higher total costs of care than two other drugs, a WellPoint executive said Thursday," Dow Jones Newswires/The Wall Street Journal reports.

28 Jun 2010

Combination MMRV vaccine associated with increased risk of febrile seizures

The combination vaccine for measles, mumps, rubella and chickenpox (MMRV) is associated with double the risk of febrile seizures for 1- to 2-year-old children compared with same-day administration of the separate vaccine for MMR (measles, mumps, rubella) and the varicella (V) vaccine for chicken pox, according to a Kaiser Permanente Division of Research study appearing online in the journal Pediatrics. A febrile seizure is a brief, fever-related convulsion but it does not lead to epilepsy or seizure disorders, researchers explained.

28 Jun 2010

Few insurers control chunk of Medicare Advantage market, report finds

A small number of insurers controls a big chunk of the market for Medicare Advantage health plans, according to a new Kaiser Family Foundation report. [KHN is a project of the Kaiser Family Foundation.] The nonprofit foundation said three or fewer companies dominate the market in every state except New York for the plans, which are privately run versions of the government's Medicare program.

25 Jun 2010

Medicare to use new fraud identification tool

Gov Info Security: "The Centers for Medicare & Medicaid Services is the first agency to use a new fraud mapping tool that ultimately will be used throughout the federal government.

25 Jun 2010

Minn. Gov. decides to not expand Medicaid early; Ohio wrestles with increased Medicaid costs in overhaul; Kansas officials worry about 25% cut in health policy operating budget

"As expected, Gov. Tim Pawlenty has declined the opportunity for Minnesota to get an early shot at expanding Medicaid eligibility. The federal health plan calls for all states to expand Medicaid eligibility to low-income adults without children in 2014, but Minnesota was among a few states offered a chance to do it earlier." The legislature, however, passed a measure that would allow Pawlenty's successor next year to reverse his ruling (Kimball, 6/22).

24 Jun 2010

90% of HCV patients to be treated with triple therapy regimens, finds Decision Resources

Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that, based on clinical profiles provided to them, surveyed clinicians estimate that one year after the launch of Vertex Pharmaceuticals/Johnson & Johnson/Mitsubishi Tanabe Pharma's telaprevir and Merck's boceprevir, at least 90 percent of hepatitis C virus patients will be treated with triple therapy regimens.

18 Jun 2010

Report reveals increase in patients influence on success, failure of new drugs

Patients are emerging as an increasingly strong group when it comes to influencing the success and failure of new drugs - according to a newly published New Health Report commissioned by Quintiles to gauge the opinions of biopharma executives, managed care executives and patients, and to track progress in the New Health.

16 Jun 2010

CSMG, CSHA awarded Elite status

Cedars-Sinai Medical Group and Cedars-Sinai Health Associates have been awarded Elite status, the highest possible designation for quality care recognized by the California Association of Physician Groups, a professional organization comprised of the state's leading managed care groups. Both organizations are ranked among the top 25 physician organizations in the state in 2010.

16 Jun 2010

Employer health costs slowing, but still face 9 percent increase in 2011

PriceWaterhouseCoopers is estimating that employer health costs will rise 9 percent in 2011, slightly less than they rose in 2010, Reuters reports. "The PriceWaterhouseCoopers team questioned 700 companies in 30 industries for the report. About 60 percent of Americans under the age of 65 get health insurance through an employer. Health benefits are often a major part of any employee compensation package. Most employers, 63 percent, offer a [managed-care] preferred provider organization or PPO, the survey found. And many have raised the deductible, with 43 percent having a deductible of $400 or more, compared to 25 percent in 2009."

16 Jun 2010

Behind the Numbers report: Employers' medical costs to increase by 9% in 2011

The nation's employers can expect medical costs to increase by 9 percent in 2011, a decrease of 0.5 percent from the 2010 growth rate, according to the annual Behind the Numbers report published today by the PricewaterhouseCoopers LLP Health Research Institute. For the first time, the majority of the American workforce is expected to have a health insurance deductible of $400 or more, as more employers return to "indemnity style" cost-sharing by raising out-of-pocket limits, replacing co-pays with co-insurance and adding high-deductible health plans.

15 Jun 2010

Successful go live of HCIM's SymKey Professional Claims, Virtual Auto-Post modules at MedPOINT Management

HealthCare Information Management, Inc. (HCIM), a nationally recognized and certified managed care information technology software and consulting services firm specializing in business process automation, announces a successful go live of their SymKey® Professional Claims module and Virtual Auto-Post™ module at MedPOINT Management, located in Woodland Hills, Calif.

14 Jun 2010

ARBs increase risk of cancer: Study

University Hospitals Case Medical Center cardiologists have uncovered new research showing an increased risk of cancer with a group of blood pressure medications known as angiotensin-receptor blockers (ARBs).

14 Jun 2010

Trauma patients without insurance more likely to die of injuries than privately insured patients: Study

Trauma patients without insurance are more likely to die of their injuries from auto accidents and gunshot wounds than privately insured patients with similar injuries, according to findings of an analysis of 193,804 patients from 649 facilities conducted by University Buffalo emergency medicine physicians.

14 Jun 2010

PAF launches CINV CareLine to assist patients with cancer, CINV

Patient Advocate Foundation – a national non-profit organization that seeks to safeguard patients through effective mediation assuring access to care, maintenance of employment and preservation of their financial stability relative to their diagnosis of life threatening or debilitating diseases – is pleased to announce that it has launched a new program, the CINV CareLine.

11 Jun 2010

Clarient becomes preferred genetic testing lab for Generation Health

Clarient, Inc., a premier technology and services resource for pathologists, oncologists and the pharmaceutical industry, today announced a new contractual agreement with Generation Health, Inc. (GH). This agreement makes Clarient a preferred genetic testing lab for GH, thereby ensuring reimbursement of diagnostic tests done for GH's nationwide network of payor clients and expanding Clarient's potential market. GH is a genetic benefit management company partially-owned by CVS Caremark, the nation's largest pharmacy healthcare provider.

10 Jun 2010

Men with MS may require education, support to manage their disease and therapy: Research

New research co-published by Saint Louis University and Express Scripts, Inc., suggests that men with multiple sclerosis may require more education and support to manage their disease and therapy than women with MS. Men also may benefit from more targeted adherence interventions.

10 Jun 2010