Recently, glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have emerged as safe and effective treatments for obesity, with ability to improve long-term cardiovascular outcomes. However, their high cost has raised concerns about their budgetary effect, particularly for public insurance programs. Medicare Part D plans statutorily cannot cover antiobesity medications, but state Medicaid programs have more flexibility.1 We examined state Medicaid coverage policies for antiobesity medications and their trends in Medicaid reimbursement from 2011 to 2022.

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Continued Medicare reimbursement declines could threaten access to physicians

These reimbursement trends varied widely by physician specialty (-57.6% for cardiac surgery to +189.1% for pain management). In comparison, non-physician practitioners’ reimbursement per Medicare patient increased more than 3-fold over the same period. The research, published today in INQUIRY: The Journal of Health Care Organization, Provision, and Financing evaluated changes in payments for Part B […]

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Insurer “Delay and Deny” Practices Continue to Threaten Patients’ Timely Access to Gastrointestinal Care – It’s Time for Reform

When a patient is struggling with gastrointestinal (GI) health issues, such as rectal bleeding, inflammatory bowel disease (IBD), or the possibility of colorectal cancer, they must immediately seek medical care. Receiving a timely colonoscopy or endoscopy is essential to developing an individually tailored treatment plan to help the patient recover.

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Reconsidering and Measuring Patient Access in Medicaid

Recent Medicaid policy discussions have focused on coverage issues because millions of beneficiaries have been disenrolled during the unwinding of COVID-19 pandemic–era eligibility protections. But access to care during a person’s enrollment in Medicaid is an equally important issue, and one that is particularly thorny to measure and address.

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Provider Strategy reports on market developments and insights related to the healthcare provider workforce. Our publication is committed to improving the healthcare professional workforce, utilization of providers, and ultimately supporting thought leadership in workforce innovation.

We are brought to you by the American Association of Provider Compensation Professionals.

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