Providers and payers are being asked to tackle the ‘upstream’ causes of poor health. Medicaid managed care organizations are being asked to screen enrollees for social needs. Some targeted efforts have translated into cost savings and make sense in value-based arrangements. But are we asking the health sector to take on too much?
Morality rates for inpatient hospitalizations for opioid abuse quadrupled between 2000 and 2014, according to a study in Health Affairs. The mortality rates increased from 0.43% before 2000 to 2.02% in 2014. In 2016, 15,000 Americans died from heroin overdoses and 20,000 others died from overdoses from synthetic opioids.
Hemlibra demonstrates how far antibody science has progressed. Genentech’s drug, approved late last year, connects two clotting factors to prevent the devastating bleeds in hemophilia patients with inhibitors. The high price may be offset by avoided costs in patients with factor VIII inhibitors.
Elisabeth Rosenthal has a unique perspective on what ails the American health care system. She is a physician turned journalist who has some firsthand knowledge about what takes place in American hospitals and doctor’s offices, although her Wikipedia entry makes a point of describing her as a “non-practicing physician.”
The rate of developmental disabilities for children ages 3 to 17 in the United States rose from 5.76% in 2014 to 6.99% in 2016, according to the CDC. The prevalence of children who had been diagnosed with a developmental delay other than autism spectrum disorder or intellectual disability also increased from 3.57% to 4.55%.
Physicians and their charges have different ideas about what makes for good cancer care. Patient surveys help, but they need to be handled right.
When it comes to heart attacks, additional health care spending was only weakly associated with lower case-fatality rates, according to a study of Medicare patients. What did make a difference to researchers was coronary angioplasty on the first day of heart attack patients’ hospitalizations.
Nonquantitative treatment limitations may be why care for mental health and substance abuse disorders isn’t keeping up with coverage gains.
The questions: Should CMS increase pay to PCPs for services that they currently provide but are not compensated for, and pay for new services that CMS would like PCPs to perform? Or should CMS pay for demonstration projects that target high-need, high-cost Medicare beneficiaries? CMS’s answer, at least for the time being, is a bit of both.
Consultants predicted it would be a major business. Large employers and insurers were experimenting with it. But medical tourism has not lived up to the heady expectations. The ACA and moderation of increases in health care costs cooled off interest. Besides, who really wants to go to an unfamiliar place for health care?
Deaths of women from opioid addiction spiked 400%, according to CDC data. Alison Colbert of Duquesne University argues for a gender-specific approach.
The plaintiffs are now defendants and vice versa in the drawn-out dispute over ACA birth control coverage.
The CNN story once again puts controversy about prior authorization into the spotlight. But is it necessary to review the entire medical record?