Articles tagged with Health Insurance
A cross-sectional study of 172 venture capital-backed maternal health startups identified significant gaps in pregnancy care delivery, particularly for low-income populations. The study found that while startups have the potential to facilitate innovation, few address health equity concerns.
Researchers urge caution on GLP-1 insurance coverage due to massive budget impact and limited data supporting long-term savings. Compounded versions of the medication can be unsafe, and patients require comprehensive support to achieve weight loss and disease prevention.
A cross-sectional study reveals substantial commercial price variation for common cardiovascular services, influenced by payer contracting strategies and market dynamics. The findings underscore the need for greater transparency and regulatory oversight to promote efficient healthcare spending.
A recent study found that frequent formulary rejections of single-source branded drugs in the US lead to delayed or absent treatment, highlighting trade-offs between cost and access to medicines. The study highlights the need for more affordable medication options, particularly for patients with chronic conditions.
After Medicare expanded coverage for Wegovy to prevent heart complications in obese patients with heart disease, prescription fills jumped sharply. However, a significant fraction of eligible beneficiaries still did not receive the treatment.
A cross-sectional study found significant increases in glucagon-like peptide-1 (GLP-1) per-patient days supplied in employer plans from 2021 to 2024, driven by higher growth in weight loss coverage. This could signal a growing financial burden on patients and payers as drug costs increase over time.
A clinical trial tested four remote monitoring approaches against usual care and found that none outperformed usual care in reducing readmissions. The study highlights the importance of studying real-world care models to optimize outcomes.
The Medicare $35 insulin out-of-pocket cap implemented in 2023 decreased and stabilized insulin out-of-pocket cost, increasing insulin use. This finding can inform policies to boost insulin access among users with high out-of-pocket cost.
A difference-in-differences analysis found that Georgia's Pathways to Coverage program worsened mental health among low-income adults. This suggests that work requirements may create barriers to coverage and care access, affecting population health and equity.
Institutional Special Needs Plan (I-SNP) enrollment was associated with significantly fewer hospitalizations for nursing home residents with dementia at the end of life, according to a retrospective cohort study. Effect sizes were larger for UnitedHealthcare (UHC) I-SNPs vs non-UHC plans. Plan maturity and volume likely impact success.
The American Society of Anesthesiologists (ASA), American College of Emergency Physicians (ACEP) and American College of Radiology (ACR) applaud the final IDR operations rule as a major step forward for No Surprises Act implementation. The rule reflects meaningful policy changes that address persistent challenges and advances a more fu...
In a cross-sectional study of ambulatory visits, digital after visit summary engagement was found to increase but remained low, especially among unmarried males, non-English-speaking populations, and publicly insured populations. This inefficiency highlights the need to reevaluate postvisit communication in these groups.
A national analysis found that robotic-assisted cholecystectomy remained linked to increased bile duct injury risks despite growing use. The study suggests small differences in overall complication rates between approaches.
A study by Norwegian University of Science and Technology found that private health insurance uptake is linked to poorer health in the population, particularly among those with low education levels. The researchers suggest that policymakers should implement strategies to mitigate this negative effect.
After Dobbs v Jackson, US abortion management shifted towards expectant approaches in ban states, with persistent reliance on suboptimal misoprostol-only regimens. State-level abortion bans were associated with a decrease in management options for individuals with spontaneous abortion in ban states.
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.
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.
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.
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.
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 $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.
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.
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 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 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.