Articles tagged with Health Insurance
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.
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.
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.
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 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 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 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 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.
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.
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.
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.
A new study found significant variation in COPD prevalence and burden across states and insurance types, with West Virginia topping the list at 143 cases per 1,000 insured individuals and Utah ranking last at 44. The study also revealed high mortality rates among people with COPD in several states.
Most Medicare beneficiaries will likely see their drug costs go up due to Part D plans' shifting cost-sharing burden. The new $2,000 annual out-of-pocket limit won't reach most beneficiaries, leading to higher deductibles and coinsurance for many.
A cross-sectional study found substantial cost shifting in veterans' surgical care from Medicare Advantage to Veterans Health Administration among high-veteran Medicare Advantage plans. This shift underscores the urgent need for policy reforms to improve the efficiency of veterans' care, as suggested by the findings.
A state Medigap guaranteed issue protection was associated with a higher rate of switching to traditional Medicare among newly diagnosed cancer patients. This finding suggests that these regulations can facilitate a switch, especially for those who desire more flexibility in accessing care.
A new study found that problems with accessing high-quality care were a major driver for switching Medicare Advantage plans, not cost concerns. Dissatisfaction with medical care access was more common among those in poor health, and those who enrolled in MA plans with low star ratings were also more likely to switch.
A new study published in JAMA Internal Medicine reveals a concerning decline in self-reported mental health among mothers in the US between 2016 and 2023. The percentage of mothers reporting excellent mental health dropped sharply from 38% to 26%, while those rating their mental health as fair or poor increased by 63.6%.
A recent study on HealthCare.gov found that burdensome reenrollment policies led to a significant decrease in enrollment and an estimated quarter of a million Americans lost their Marketplace health insurance coverage in 2024. The researchers argue that increasing administrative burdens will lead to more coverage losses.
New research reveals that recreational cannabis legalization leads to significant reductions in prescription drug claims per enrollee, with annual savings of $34-$42 in small group insurance markets. However, the study found no similar effect in large group insurance markets.
A study found that veterans enrolled in Medicare Advantage (MA) plans use dental and vision services at a similar rate as those in traditional Medicare. MA plans spent only slightly more on these services, including emergency dental care. After accounting for private insurance coverage, the total spending on dental services was compara...
A recent study found that more beneficiaries were affected by insurer exits in the Part D marketplace under the IRA, which increased plan sponsor financial liability. The redesigned Part D marketplaces may lead to limited coverage options and less competitiveness.
A new University of Michigan study suggests that Medicaid unwinding may have disrupted the care of people receiving treatment for opioid addiction. Patients were less likely to continue filling buprenorphine prescriptions and more likely to pay with cash or private insurance in states with large versus small Medicaid enrollment drops.
This study found a decline in racial and ethnic disparities in receipt of ERBB2-targeted therapies among older Medicare beneficiaries with ERBB2-positive breast cancer. The narrowing of disparities may be attributed to changes in healthcare practices or policies over time.
A new poll by Michigan Medicine reveals that nearly two-thirds of Americans over 50 believe Medicare will cover their nursing home costs, despite it not currently paying for this type. Only half have taken key actions to prepare for long-term care needs. The poll also shows that 70% of people who survive to age 65 will need long-term c...
A new analysis predicts that reducing Medicaid access could lead to thousands of additional deaths among working-age Americans and disastrous financial burdens. The study found that eliminating the ACA provision expanding Medicaid access could drive millions to delay needed care.
The study estimates that expanded Medicare coverage for GLP-1RAs would increase access to these treatments and reduce obesity-related comorbidities. However, this would come with substantial costs over a decade, projected at $8 billion, highlighting the need for further price reductions and cost-saving strategies.
The percentage of publicly insured children receiving mental health or neurodevelopmental disorder diagnosis increased significantly between 2010 and 2019. Most diagnostic categories showed increases, emphasizing the importance of accessing appropriate services in safety net systems.
Families of children with disabilities experience higher adjusted odds for financial hardships due to inadequate health insurance policies. The study highlights the need for structured policies ensuring covered medical care without financial burden on families.
A study of over 300,000 adults found that those with diabetes are 25% more likely to lose their health insurance. Insurance instability is particularly concerning for those with complex needs, as many struggle to regain coverage after losing Medicaid or private insurance.
A study found that 76% of people aged 50+ have patient portal accounts, with 65% sending at least one message in the past year. However, 13% report paying co-pays or charges for these interactions, especially those with Medicaid or low incomes.
Tariffs on Canadian pharmaceuticals could significantly impact the US drug supply and costs, with an estimated $750 million added to production costs. The study found that $3 billion in US pharmaceuticals rely on Canadian manufacturing, highlighting the potential fragility of supply chains.
A new white paper finds that expanding access to anti-obesity medications can prevent or delay chronic disease by years, providing significant societal benefits. The study estimates a $10 trillion return on investment and 13% annual returns on investment for society.
Most older U.S. adults support Medicare covering weight management medications, particularly those with a BMI of 30 or greater. The survey also found that more than half of participants were interested in using these medications to manage their weight.
A large majority of older Americans believe health insurance – including Medicare – should cover anti-obesity medications. Nearly 37% of respondents met the criteria for overweight and 36% for obesity. Medicare currently covers a drug used for weight management but only in people with diabetes or a history of heart attack or stroke.
A study published in the International Journal of Manpower found that offering paid time off (PTO) significantly reduces the likelihood of employees quitting their jobs, with a greater reduction for men. PTO does not affect job satisfaction, which independently reduces turnover by 30-40%. Flexible scheduling also reduces turnover, but ...
A new study found that less than half of Medicaid managed care plans cover all four FDA-approved medications for treating alcohol use disorder. The majority of these plans covered naltrexone, while disulfiram and acamprosate were less commonly covered.