Articles tagged with Health Insurance
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A new study by OHSU-led researchers found that nearly one-third of physicians enrolled in Medicaid don't actually care for a single patient covered by Medicaid insurance. This 'ghost' phenomenon hinders access to healthcare, leading to delayed or foregone care and ultimately increasing costs.
A cross-sectional analysis of nationwide population data reveals that high-deductible health plans are associated with worse overall and cancer-specific survival among cancer survivors. The study suggests that financial disincentives for medical care may lead to delayed or foregone necessary care, ultimately worsening cancer outcomes.
A cohort study found that Medicaid expansion under the Affordable Care Act was associated with lower overall mortality among women with breast cancer aged 40-64. The benefits of expanded coverage were uneven, highlighting persistent disparities in healthcare access for certain populations.
A new USC white paper reveals that PBMs' reported profit margins are influenced by accounting practices, making it challenging for policymakers to understand the true cost drivers. The researchers suggest requiring financial transparency from PBMs to develop a better picture of their operations and costs.
A new study finds that hospitals treating more patients with Medicare Advantage plans face higher readmission penalties despite taking similar actions to prevent repeat hospitalizations. The analysis highlights the need to incorporate Medicare Advantage data into the Hospital Readmissions Reduction Program.
Commercially insured patients frequently bypass rural hospitals between 2012 and 2021, generating large payments for receiving hospitals. The findings highlight the need for addressing this issue to alleviate financial distress on rural healthcare facilities.
A Medicaid policy promoting high nursing home staffing levels was associated with modest improvements in patient health. The study estimates that similar reform nationwide could prevent 6,142 fewer hospitalizations annually.
A recent University of Michigan study analyzed over 60 million Medicare participants and found that total visits remained stable or declined slightly through June 2024. Despite widespread adoption of telehealth, overall healthcare visits stayed steady or decreased, contradicting predictions of increased utilization.
A cohort study found associations between exposure to multiple fine particulate matter components and increased depression risk among US Medicare population members. The study highlights the importance of targeted regulation to protect vulnerable populations from harmful air pollution.
Chronic pain prevalence differs between rural and urban adult cancer survivors, with rural areas showing higher rates despite having fewer resources. Limited access to pain specialists and insurance challenges contribute to these disparities.
Behavioral health spending in the US increased significantly between 2017 and 2022, reaching 40% of child health spending. This shift is associated with high family financial burdens due to expanded access to services and supports through insurance coverage and clinician availability.
A repeated cross-sectional study found a significant increase in stimulant prescribing for ADHD, with the largest acceleration observed among female adolescents and young adults aged 18 to 64. The study's findings are consistent with prior research but provide new insights into population-level trends.
A study published in JAMA Network Open reveals low adherence to cervical cancer screening guidelines among commercially insured US adults, with only 7.3% following recommended guidelines. The findings suggest that guideline confusion and lack of incentives are contributing factors to this issue.
Health insurance premiums rose at rates close to hospital prices during the COVID-19 pandemic but have since stabilized, reflecting shifts in healthcare utilization. Insurance premiums increased 3 times faster than workers' earnings since 1999, accompanied by rising hospital costs.
A Rutgers Health-led study found that Medicaid expansion increased PrEP prescriptions overall, but racial disparities in access persisted. White Americans received the most PrEP prescriptions (94%), while Black and Hispanic communities were underrepresented, with 13% and 24% respectively.
A new study found that access to wheelchairs through Medicare-listed suppliers is inconsistent and often challenging due to administrative requirements and long delivery timelines. The research highlights the need for policy changes to assist vulnerable older adults in accessing critical medical equipment.
Researchers analyzed insurance claims data from US health insurers to demonstrate the cardiovascular benefits of semaglutide and tirzepatide. Both GLP-1 drugs provide cardioprotective effects, reducing the risk of stroke and heart attack by 18% and 13%, respectively.
Researchers found that people with high blood pressure who took a daily chance to win cash were more likely to take their medication consistently. However, they did not achieve significantly better blood pressure reductions compared to those without financial incentives. The study suggests that improving long-term behavior changes is c...
Premature mortality among adults aged 18-64 increased by over 27% between 2012 and 2022, with racial disparities widening substantially. Despite contributing to Medicare, Black individuals are less likely to live long enough to reach the qualifying age for coverage, resulting in unrealized benefits.
A new study from Tulane University found that 22 states have prohibited prior authorization for opioid use disorder medications, making it easier for people to get potentially life-saving treatment. This trend signals a positive shift in state legislative efforts to address the opioid crisis, with more states removing barriers to care.
A University of Michigan study found that Medicaid coverage is linked to employment gains among low-income adults with serious health problems. Employment nearly doubled among enrollees who experienced improved health, from 26% to 47%. This suggests that Medicaid expansion may actually help individuals participate in the workforce.
The study found that stillbirth rates are higher in low-income communities compared to more affluent areas, highlighting the need for targeted interventions to address social determinants of health
Colorectal cancer screening modities shifted among privately insured individuals after COVID-19, with decreased colonoscopy and fecal tests, increased stool DNA tests. Differences found by sex, socioeconomic status, and metropolitan area residence.
The study found a 6.3% increase in participating physicians between 2013-2023, with those in nonmetropolitan counties and full-shortage Health Professional Shortage Area counties more likely to exit the program. This trend is expected to reduce access to care for already underserved communities.
A recent study found that cannabis may reduce opioid use among commercially insured patients with cancer diagnoses, indicating potential benefits for pain management. However, further research is needed to confirm the efficacy of cannabis as a treatment for cancer-related pain.
A cohort study found that 40% of GLP-1RA orders were not filled, with lower rates among Non-Hispanic Black and Hispanic patients. These disparities may be attributed to differences in insurance coverage, GLP-1RA use, or cost thresholds.
A nationwide analysis found that emergency Medicaid accounted for less than 1% of overall Medicaid spending in states with large undocumented populations. States with larger undocumented populations spent more per capita, but still faced minimal cost savings from cuts to emergency Medicaid.
A new study shows that direct-to-consumer pharmacy pricing can offer lower total costs (431% lower) compared to commercial pharmacies for insured patients. Out-of-pocket neurologic drug costs are 75% higher, but most medications cost less than $635 per year.
A recent study published in Cancer Discovery found that Medicaid expansion is associated with improved five-year cause-specific and overall survival rates among cancer patients. The research showed significant improvements in survival rates for patients living in rural areas, high-poverty areas, and those with higher-mortality cancers.
A cross-sectional study of primary care patients found significant disparities in patient-portal message responsiveness by race and ethnicity, insurance type, and preferred language. Slower response times at underserved practice settings contributed to these disparities.
Approximately 5 million adults are at risk of Medicaid disenrollment due to HR 1's work requirements, with a high prevalence of chronic and function-limiting conditions. This population is particularly vulnerable to the impact of work requirements on their health outcomes.
A study published in The BMJ found that Medicaid expansion with work requirements did not increase health insurance coverage or employment among working-age adults with low incomes. In fact, Medicaid coverage decreased in Georgia by almost 12 percentage points compared to a state without work requirements.
Commercial health plans in the US impose different coverage requirements for FDA-approved cell and gene therapies, often aligning with pivotal trial criteria. These restrictions suggest a need for stronger evidence to support plan coverage.
A new study finds that Medicaid unwinding is associated with a decrease in medication treatment for opioid use disorder, with the greatest declines seen in states with large disenrollments. The study's findings have relevance for upcoming Medicaid cuts, which may impact access to life-saving medication for individuals battling addiction.
A study reveals that nearly 3 of 4 US children relied on publicly subsidized insurance or experienced uninsurance by age 18. State-level heterogeneity underscores the significance of Medicaid policies in addressing childhood un-insurance.
Prior authorization for glucagon-like peptide-1 receptor agonists (GLP-1RAs) became near universal, leading to substantial out-of-pocket costs. Out-of-pocket costs for GLP-1RAs rose significantly from 2020 to 2025, affecting many high-cost drugs.
A new study found that three in five US children enrolled in Medicaid or the Children's Health Insurance Program (CHIP) by age 18. The researchers used a microsimulation model to track childhood insurance coverage over 18 years, estimating cumulative insurance outcomes under policy conditions similar to those between 2015 and 2019.
After ACA, usual source of care increased from 67% to 68%, with gains in low-income rural and urban areas. Insurance barriers decreased, while accessibility and individual preferences improved for low- and middle-income adults.
Dr. Alan Sager presents a guide to thorough healthcare reform in the US, citing high costs and inadequate insurance coverage as major issues. He proposes solutions such as containing costs safely, insuring all Americans, and securing adequate pay for doctors and hospitals.
A retrospective cohort study found that children of racial and ethnic minority groups receiving CPR had higher odds of in-hospital mortality. Additionally, the odds of in-hospital mortality among children receiving CPR were higher at hospitals with the highest proportion of Black patients.
A new study found that the end of COVID-era federal funding led to a significant increase in uninsured children visiting emergency departments in Texas, with 45.2% more visits than before. The share of commercially insured patients also rose 12.5%, while Medicaid-insured visits declined by 11.7%.
A UCLA Health study found that taking an 8-strain probiotic daily reduces the risk of pouchitis, a common inflammatory condition. However, the treatment's cost-effectiveness depends on the patient's likelihood of flare-ups, with benefits only seen in patients with frequent relapses.
A cross-sectional study found that Asian, Black, and Hispanic transgender beneficiaries have high prevalence of cardiovascular conditions. These disparities are attributed to the intersection of gender, race, and ethnicity, highlighting the need for targeted support.
Researchers found a 9% increased risk of death from all causes for those living in flood-affected zip codes, with higher risks in Connecticut and New York City. The study highlights the importance of considering long-term health impacts of hurricane-related flooding on older adults.
A recent study found that children adopted internationally by non-US citizens living in the US have the highest uninsured rate at 30.7%. This group also had lower rates of private and public health insurance compared to other adoptee groups, highlighting the need for tailored policies to address these disparities.
A large study found that Medicare beneficiaries with multiple sclerosis who received broader coverage of MS treatments had significantly lower risk of developing new or worsening symptoms. Researchers warn that formulary exclusions for specialty drugs could lead to worse health outcomes.
A new study published in JAMA Health Forum suggests that Medicare could save $3.6 billion annually by eliminating or reducing low-value tests and procedures for patients who do not benefit from them. This reduction in unnecessary care could also result in $800 million less in out-of-pocket costs for older adults.
A study found that semaglutide and liraglutide use are associated with a higher risk of nonarteritic anterior ischemic optic neuropathy in older patients with type 2 diabetes. The GLP-1 receptor agonists showed varying levels of risk, with liraglutide posing the greatest threat.
Two studies from University of Michigan researchers suggest many older adults and people with disabilities need more impartial help picking the best Medicare plan. Only about 13% of enrollees switch plans annually, and even fewer use the internet to research options.
A study by researchers at UCSF found that young patients who received eight or more outpatient therapy sessions after a hospital stay were 25 times less likely to be readmitted. The therapy was delivered by community-based clinicians and did not require specialist expertise. This simple yet effective approach has the potential to break...
A recent study by JAMA Network Open reveals racial differences in care quality among men with newly diagnosed prostate cancer. Black men had lower odds of overtreatment, suggesting better care, while having lower odds of confirmatory testing on active surveillance, indicating worse care.
Patients with common cancers face significant out-of-pocket costs after diagnosis, with the most advanced cases having the highest expenses. Further research is needed to understand the clinical and financial implications of these costs.
Physician exit from traditional Medicare has increased over time, with exits remaining high even after the pandemic. The findings suggest that multiple factors contribute to physician departures, including the growing burden of new communication methods and demands for clinical documentation.
Proposed Medicaid reforms would have far-reaching consequences beyond federal budget savings, including negative health outcomes and economic losses. Rural and underserved communities are disproportionately affected by these policy changes.
A new study found that extending Medicaid coverage for 12 months after birth improved access to medical and behavioral health services. This expansion may help mitigate adverse outcomes, including chronic condition management.
The Families First Coronavirus Response Act led to a significant decrease in Medicaid health insurance loss. The study found that the Act reduced the risk of losing health insurance for individuals enrolled in the Medicaid program.
Eliminating the fee increased overall usage by 7.8 percentage points, particularly benefiting underserved populations, including non-English speakers and those from socioeconomically disadvantaged areas. Despite gains, some disparities persisted, highlighting the need for additional strategies to ensure equitable access.
A new study found that almost all Medicaid managed care plans (MCPs) cover at least one form of naloxone, with 94% covering generic injectables or 4-mg nasal sprays. However, certain restrictions and quantity limits may prevent people from accessing this life-saving drug.
Most opioid treatment programs still do not offer all three forms of medication-assisted treatment (MAT) as of 2023. Government-operated programs and those accepting Medicare are more likely to provide comprehensive MAT offerings.
Access to buprenorphine and naltrexone for opioid use disorder is affected by race and ethnicity, as well as insurance type. Targeted interventions, including culturally tailored care and expanded access points, are needed to address disparities and reduce inequities contributing to the overdose crisis.