Articles tagged with Health Insurance
A Brown University study found that expanded Medicaid coverage significantly improves one-year mortality rates for young adults with kidney failure. The researchers discovered improvements in pre-dialysis care, increased use of dialysis, and longer dialysis sessions, all leading to better long-term health outcomes.
A retrospective study found lower in-hospital mortality and emergency department use within 30 days of discharge for Medicare beneficiaries undergoing hospital at home compared to traditional inpatient care. However, hospital readmissions within 30 days showed no significant difference between the two approaches.
A cohort study found that ultraexpensive drugs in Medicare Part D have limited international availability, highlighting their fiscal significance. Internationally unavailable products often result in higher spending per beneficiary.
A new study found that Michigan Medicaid expansion helped enrollees significantly reduce their medical debt in collections by up to 75% within seven years of enrollment. Additionally, the study shows substantial drops in sub-prime credit scores, improving financial stability and long-term health outcomes.
The study found that out-of-state Chicago Abortion Fund callers traveled more than 3 times the distance to Illinois after Dobbs compared to before. These callers were also more likely to have private or no insurance, be from rural areas, and receive hospital-based care during their pregnancy.
A cross-sectional study found a substantial increase in medication use for opioid use disorder among Medicaid beneficiaries, potentially contributing to reductions in overdose deaths. The study suggests that expanding access to medications for opioid use disorder may be an effective strategy to address the opioid crisis.
A nationally representative study found nearly 1 in 10 U.S. adults with heavy drinking and obesity conditions, highlighting the need for preventive efforts in younger and middle-aged adults without insurance or Medicaid coverage to curb rising rates of alcohol-associated liver disease deaths.
A new analysis from UC San Francisco argues that diagnostics are being overlooked, slowing progress against major diseases despite advances in targeted therapies. The study suggests that nearly half of the world's population lacks adequate access to diagnostics due to inadequate investment and insurance reimbursement.
Long-term opioid therapy prescription rates declined in the US from 2015 to 2023, despite a growing population of older adults receiving these treatments. Approximately 4-5 million patients were prescribed long-term opioids in 2023, with Medicare covering a larger proportion, raising concerns about safety.
Public long-term care insurance in China's pilot program cuts catastrophic health spending by up to 52%, shifting care away from costly medical interventions. This model offers a powerful alternative for value-based end-of-life care.
Advanced or metastatic cancers often go without tumor genomic testing, with those from low-income backgrounds facing longer wait times. JAMA Network Open highlights the need for targeted healthcare policies to bridge these gaps.
A $35 monthly insulin out-of-pocket cap is associated with significantly lower insulin costs, increased access to insulin, and decreased blood glucose levels among Medicare beneficiaries. This finding suggests that federal cost-sharing policies could improve access to essential medications in diabetes.
Coupon programs shifted towards higher-cost drugs, offering larger incentives to offset increasing patient cost-sharing requirements. Manufacturer-sponsored coupons saw a significant decline between 2017 and 2024, while per-claim coupon amounts rose accordingly.
A lower semaglutide price could generate savings that offset the cost of treating an additional 550,000 to 3.6 million Medicare beneficiaries eligible for expanded obesity-indication coverage. This voluntary price agreement may lead to substantial savings for Medicare spending on semaglutide treatment.
A case-control study found that insurance churn is associated with poorer diabetes management, increased insulin use, and acute complications. Continuous insurance coverage for low-income diabetic patients may lower risk of costly preventable complications.
The American Society of Anesthesiologists (ASA) has filed an amicus curiae brief to support NorthStar Anesthesia in a lawsuit with UnitedHealthcare. ASA warns that insurers bypassing Congress' framework undermines the No Surprises Act and threatens patient access to care. The organization advocates for administrative remedies over frau...
A new study reveals that prior authorization requirements for heart failure medications can significantly delay pharmacy fills, particularly for those with lower socioeconomic status or Medicaid insurance. The study found that patients with prior authorization prescriptions took three times as long to fill their ARNI prescriptions and ...
A $3 million NIH grant funds a national study on Medicare Advantage's new non-medical benefits, including groceries, meal deliveries, utilities, transportation, and other services. The study will examine the impact of these benefits on health care use and patient outcomes.
Patients who are dual-eligible for Medicare and Medicaid, or enrolled in Medicare Advantage plans, are less likely to receive high-quality postacute care after a stroke. This disparity highlights the need for equitable access to specialized care to improve outcomes for high-need patients.
A new study reveals that neighborhood characteristics, including poverty and lower educational attainment, are associated with higher COPD-related emergency department visits and hospitalizations. Community-level interventions targeting these risk factors can help improve quality of life and reduce acute care use.
A study found that 13.4% of young adults with complex medical conditions were disenrolled from Medicaid at age 19, compared to 35.6% without such conditions. The study highlights the significant impact of coverage disruptions on health outcomes for medically complex patients.
Enrollment among eligible individuals increased by 27.5% after subsidy expansion, with gains seen among children 18 and under, Black and Hispanic individuals, part-time workers, and rural residents. The study found that 7.8 million enrollees retained marketplace coverage over the 2021-2022 period
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.
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 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.
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.
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.
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 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.
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.
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.