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| http://dx.doi.org/10.1080/00913847.1996.11948043 | DOI Listing |
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Use of and Steering to Pharmacies Owned by Insurers and Pharmacy Benefit Managers in Medicare.
JAMA Health Forum
January 2025
Department of Population Health Sciences, Weill Cornell Medical College, New York, New York.
Importance: The prevalence of pharmacies owned by integrated insurers and pharmacy benefit managers (PBMs), or insurer-PBMs, is of growing regulatory concern. However, little is known about the role of these pharmacies in Medicare, in which pharmacy network protections may influence market dynamics.
Objective: To evaluate the prevalence of insurer-PBM-owned pharmacies and the extent to which insurer-PBMs steer patients to pharmacies they own in Medicare.
Prevalence of Adverse Childhood Experience Exposure by Disability Status.
JAMA Health Forum
January 2025
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles.
Medicaid Unwinding Experiences in Dual-Eligible Older Adults.
JAMA Health Forum
January 2025
Division of General Internal Medicine, University of Pennsylvania, Philadelphia.
Importance: Dual-eligible older adults rely on Medicaid to pay for Medicare premiums and cost sharing in addition to supplemental services including dental and long-term care. However, the unique experiences of dual-eligible older adults with Medicaid unwinding remain unknown.
Objective: To assess the awareness and experiences of dual-eligible older adults with Medicaid redetermination.
High-Cost Cancer Drug Use in Medicare Advantage and Traditional Medicare.
JAMA Health Forum
January 2025
Department of Health Systems, Management, and Policy, University of Colorado Cancer Center, Aurora.
Importance: Medicare Advantage (MA) plans are designed to incentivize the use of less expensive drugs through capitated payments, formulary control, and preauthorizations for certain drugs. These conditions may reduce spending on high-cost therapies for conditions such as cancer, a condition that is among the most expensive to treat.
Objective: To determine whether patients insured by MA plans receive less high-cost drugs than those insured by traditional Medicare (TM).
Firearms Industry Immunity From Safety Regulation-A Call to Action.
JAMA Health Forum
January 2025
Department of Emergency Medicine and Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee.
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