AHIP (formerly America’s Health Insurance Plans) released a statement yesterday saying that their health plan members “announced a series of commitments to streamline, simplify and reduce prior authorization.” 48 US health plans signed off on the statement. What were AHIP’s 6 commitments? Standardizing Electronic Prior Authorization. Participating health plans will work toward implementing common, transparent submissions…
While expanding access to VBC in primary care is indeed an important goal, we must keep in mind that the vast majority of healthcare expenses are in specialty care areas like oncology, where costs continue to rise without improved patient outcomes. The post Easier Said Than Done: Why Scaling Up Value-Based Care is So Hard…
What if we placed the needs of the most vulnerable at the heart of healthcare innovation? This isn’t simply about equity; it’s about unleashing a wave of creativity that could transform healthcare for everyone. The post Trickle-up Innovation: The Unexpected Benefits of Designing Healthcare from the Bottom Up appeared first on MedCity News.
Many healthcare executives are applauding the list of additional drugs chosen for the Medicare Drug Price Negotiation Program, while some drug companies are opposing it. The post How Healthcare Leaders Reacted to the 15 Additional Drugs Selected for Medicare Negotiation Program appeared first on MedCity News.
This brief examines the two presidential candidates’ records and other recent policy proposals that could inform starkly different directions for the program across key areas, including Affordable Care Act (ACA) Medicaid expansion, financing, eligibility, benefits, and cost-sharing, prescription drugs, long-term services and supports, and managed care.
Unauthorized switching of Affordable Care Act plans appears to have tapered off in recent weeks based on an almost one-third drop in casework associated with consumer complaints, say federal regulators. The Centers for Medicare & Medicaid Services, which oversees the ACA, credits steps taken to thwart enrollment and switching problems that triggered more than 274,000…
A California agency charged with slowing health costs has set a lofty goal for insurers to direct 15% of their spending to primary care by 2034, part of the state’s effort to expand the primary care workforce and give more people access to preventive care services. The board of the state Office of Health Care…
On a recent weekday evening, Ashly Richards helped her 13-year-old son, Case, with homework. He did math problems and some reading, underscoring how much he’s accomplished at his school for children with autism. Richards has heard Trump administration officials suggest that food dyes and pediatric vaccines cause autism and ADHD. That stance, she said, unfairly…
Zepbound’s clinical tests in obstructive sleep apnea showed improvement in breathing disruptions that were accompanied by reductions in body weight. The new approval gives the Eli Lilly medicine the opportunity to become a blockbuster seller in yet another indication. The post Eli Lilly’s Zepbound Becomes First FDA-Approved Drug Therapy for Sleep Apnea appeared first on…
Several years ago, Highmark began questioning its exclusive relationships with specialty pharmacies and started working with Free Market Health, which matches patients to the pharmacy that best fits their needs. The post Why This Health Plan Moved Away from Exclusive Relationships with Specialty Pharmacies appeared first on MedCity News.