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The Impact of New Medicaid Work Requirements on People with Cancer

... their doctor submit a form demonstrating or verifying an inability to work. This gets more complicated for people who have not had consistent health insurance coverage or easy access to doctors and care – like people who live in rural areas. By severely limiting the use of self-attestation after the first year of implementation, people with ... with Disabilities Act, are exempt. This helps ensure that people who must disrupt their work to care for a loved one will be able to keep their health coverage. Most cancer caregivers will not have to choose between working or providing care to their loved one with cancer in order to keep ...

Step Therapy in Medicare Part D Oncology Drugs

Executive Summary Escalating drug costs in the United States are placing pressure on both the federal government and health plans to implement strategies aimed at controlling drug expenditures and optimizing utilization. Utilization management (UM) tactics are ...   SNPs provide the same Medicare Parts A and B coverage for beneficiaries as other MA plans but also offer tailored benefits and coordinated care for beneficiaries that have specific health conditions or meet other requirements. Step Therapy in Medicare Part D Oncology Drugs ...

Survivor Views: Copay Assistance and Patient Navigation

... note at end). The margin of sampling error associated with a sample of this size is +/-2.8% at a 95% confidence level.  Key Findings: Cancer care is expensive and prescription drug costs are a challenge for nearly one-third of cancer patients and survivors (31%), with one-fifth having ... the survey. For this survey, a patient navigator was defined as follows: “Patient navigators help guide patients through the often-complicated health care system with the resources they need to get care. A patient navigator helps patients communicate with their healthcare providers so they get the information they need to make decisions about their health care. Patient navigators may also help patients set up appointments for doctor visits and medical tests and get financial, legal, and social ...

Utilization Management in Breast Cancer and Hepatocellular Carcinoma

Executive Summary Utilization management (UM) refers to a variety of practices that health plans and pharmacy benefit managers employ to confirm the use of specific drugs or services aligns with the payer’s policy. Plans can use ... necessary, or to limit utilization of high-priced, specialty medications. UM use in oncology may have unintended consequences to patient care, such as delaying patient access to medication or increased administrative burden for the patient and provider. Prior to 2019, Medicare ...

Understanding Biologic and Biosimilar Drugs

... that they are generally larger, more complex molecules. Biologics are usually administered via injection or infusion. Most biologics in cancer care are given under the close supervision of a medical professional.  Biologics have been a part of medical treatment for a long time and have ... one, some, or all of the conditions of the reference product. While the safety of a biosimilar is assured through FDA review and approval, your health care provider should review the product label for any prescribed biosimilar.  Why biosimilars were introduced Biosimilars were introduced ... to you by your healthcare provider. This might be for several reasons, including that the biosimilar is the preferred product of your doctor or health plan. This preference might also come from physician’s experience with the product, a desire by your health plan to control costs, or ...

National Screening Survey

... say they aren’t sure and don’t regularly have a provider who lets them know when it’s time for a screening. Those with employer-provided health plans and Medicare enrollees are significantly more likely to say they know what their recommended screenings are and when to get them (69% ... annually compared to 55% of those in households earning less than $55k per year). Ninety-four percent of respondents report having a primary care doctor, and 93% say they typically see a primary care doctor at least once per year. Ninety-one percent have seen a primary care doctor within ... advocacy affiliate, ACS CAN has successfully advocated for billions of dollars in cancer research funding, expanded access to quality affordable health care, and advanced proven tobacco control measures. We stand with our volunteers, working to make cancer a top priority for policymakers in ...

Survivor Views on Social Connection & Isolation

... at least some of the time, a number similar to recent national surveys. Numerous studies describe the link between social isolation and negative health outcomes, [1] and a 2023 study by the American Cancer Society identifies an increased mortality risk among cancer survivors with higher ... reporting this impacted their connections a great deal. Other factors impacting social connection include stress, depression, or other mental health concerns (50%), missing or stopping work (45%), and those in their social circles feeling scared to talk to them, not knowing what to say, ... times to tell my loved ones because I didn't want to burden them, but then they would tell me it would not burden them, it would help them take care of me better.” “Teaching caregivers/supporters good questions to ask, things not to say, or how to just hang out in silence.” ...

Choice in Treatment Modality Overwhelmingly Important to Cancer Patients & Survivors

... advocacy affiliate, ACS CAN has successfully advocated for billions of dollars in cancer research funding, expanded access to quality affordable health care, and advanced proven tobacco control measures. We stand with our volunteers, working to make cancer a top priority for policymakers in cities, ...

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