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Enrollment in Affordable Care Act marketplace plans has reached record levels, and the Biden administration is using those numbers to push for continuation of enhanced subsidies that have lowered premiums for the plans.

Briana Contreras, editor of Managed Healthcare Executive spoke with Emad Rizk, M.D., chairman, president, and CEO of Cotiviti in this week's episode of Tuning In to the C-Suite. In the discussion, they talked about the issues of risk in healthcare and how they have led to inequalities in care. They also addressed how adopting risk assessment tools that expand access to data around social determinants of health can help reduce bias and improve care.

AMCP 2022 Wrap-Up

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About 3,000 people attended the Academy of Managed Care Pharmacy's annual meeting in Chicago last week.

HIV PrEP uptake was highest for White and Black males and lowest for Hispanic males. Meanwhile, Black females had the highest uptake and twice the rate of PrEP uptake of White females.

The proposed funds include $165 million more for the Ryan White HIV/AIDS Program, $47 million more for HIV and hepatitis prevention activities at the Indian Health Service, and $115 million for CDC HIV prevention programs.

The FDA authorizes second COVID-19 booster and approves a higher does of Ozempic, Cabenuva for adolescents with HIV, a therapy for rare seizer disorder, and an oral testosterone replacement. The agency issues a complete response letter for a therapy for anemia related to chronic kidney disease, and an advisor committee votes down a drug for ALS.

Over 130 digital therapeutics for behavioral health are in the pipeline, but many payers are still sussing out how best to evaluate them and perhaps provide coverage, according to panelists at AMCP 2022. And for all of their advantages, digital therapeutics have some notable limitations and drawbacks.

Patients who live in rural areas incur a variety of costs attributed to physically getting into the office to meet with their doctor when the need arises. When those patients require more frequent visits for chronic disease management, the cost of transportation, missed work, out-of-pocket copays, and any number of other costs can become a substantial barrier to care.

Spending growth sank from 9.7% in 2020 to 4.2% in 2021 as special pandemic-related programs tapered off, according to CMS actuaries. But in article published in Health Affairs they project spending growth to continue at a steady clip this decade with the country’s total spending on healthcare project to reach $6.751.5 trillion by 2030.