Medicaid managed care saved $6.5B on drugs in 2018 | Mich. insurer: Value-based model and maternal care gaps | Aetna partners with Ga. health systems for Whole Health
A Menges Group study commissioned by AHIP found Medicaid managed care organizations saved $6.5 billion on prescription drugs in fiscal 2018. Medicaid managed care plans had 27% lower net costs per prescription than traditional Medicaid, and drug costs also increased more slowly in MCOs, suggesting that "[w]hen states rely on Medicaid managed care plans to provide integrated drug benefits to enrollees, they do even better and deliver more savings for taxpayers every day," according to AHIP President and CEO Matt Eyles.
Priority Health announced that it will offer financial incentives to health care providers who will adopt the Centering Healthcare Institute's CenteringPregnancy value-based care model as part of efforts to reduce racial disparities in maternal and infant mortality rates in Michigan. "By incentivizing Centering visits, Priority Health is recognizing the investment required by providers to transform care delivery from an individual to a group care model," according to a Priority Health press release.
Northside Hospital System and Emory Healthcare are teaming up with Aetna in its Whole Health project that will allow program members to gain access to hundreds of physicians at the two Atlanta-based health systems. Under the initiative, Aetna will offer Emory and Northside with fully insured and self-insured network options to its health maintenance organization and exclusive produce organization products.
Seven provider groups have agreed to join the Blueprint for Affordability value-based care program initiated by the Blue Cross Blue Shield of Michigan, bringing the total number of provider participants to 14 and extending the model's reach statewide. Under the model, providers who won't exceed the annual targets for the costs of care to BCBS members will receive financial rewards, while those who exceed should reimburse BCBS.
A study in JAMA Network Open found Medicare patients of hospitalists with high rates of referring for specialty consultation had longer lengths of stay and were less likely to go home, compared with patients of other hospitalists. Mortality and readmissions were not significantly different between the groups, but patients of hospitalists with high consultation rates did have higher costs and were more likely to see an outpatient specialist within 90 days of hospital discharge.
The American Academy of Pediatrics issued a clinical report urging pediatricians to promote physical activity by evaluating and documenting physical activity and literacy and gross motor skill development during health visits; discussing how physical activity affects physical and social growth and health management; and encouraging parents to be active themselves. Pediatricians should also provide resources and tools that encourage physical activity and support opportunities for youths with physical activity challenges, according to the report.
Head CT images of patients with symptoms of acute stroke displayed on a smartphone or laptop are reliable and accurate for recommending intravenous thrombolysis, according to a study in the American Journal of Roentgenology. The researchers found good or very good inter- and intraobserver agreement on five variables, suggesting that mobile-based telestroke services could increase access to neuroradiologists, study leader Antonio Salazar said.
Patients with diabetes, particularly those with greater clinical needs, showed better adherence to oral diabetes medications, as well as lower glycemic levels, when given mobile patient portal access, according to a study published in JAMA Network Open. The findings, based on a study of 111,463 patients with diabetes, suggest that "adding mobile portal access may be an important gateway for reaching and improving care," the authors wrote.
The CDC's 2020 National Diabetes Statistics Report revealed that more than 1 in 10 US adults -- about 34.1 million -- have either type 1 or type 2 diabetes, and 7.3 million of them don't know they have the disease or did not report having it. The prevalence of diagnosed diabetes was highest among Native Americans and Alaskan Natives, followed by Hispanic adults and black adults, and 89% of those with diagnosed diabetes had overweight or obesity, 38% were physically inactive, 21.6% were tobacco users, 15% were cigarette smokers and 36.4% had stopped smoking.
A study in JAMA Network Open found alcohol-induced deaths increased between 3.1% and 3.6% per year for women and from 1.4% to 1.8% for men from 2000 to 2016. Rates increased across the country, including urban and rural areas, and wealthier and poorer counties, said lead researcher Susan Spillane.
Parents of 37% of children ages 19 months to 35 months don't follow the CDC Advisory Committee on Immunization Practices' recommended vaccine schedule and either had "alternate" or "unknown" immunization schedules for their children, while fewer than 60% were up-to-date on all vaccines recommended by the ACIP, according to a study in Pediatrics.
What's ahead for Medicare and Medicaid? At AHIP's National Health Policy Conference (March 18 and 19 in D.C.), CMS Administrator Seema Verma will share her agency's 2020 policy priorities. See all the speakers and sessions. Register now.
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