News Wire

Legislation stands no chance in the Republican-controlled Senate
Report recommends more CMS oversight and audits
Some Democrats crossed party lines in the 72-18 vote on Thursday
Commonwealth Fund survey finds huge gap between the U.S., other high-income countries
Adams promises to carry out Bernard Tyson's vision
Company says it is offering a more affordable generic to the agent used to treat varicose veins
Rozanolixizumab touted as possible alternative to standard therapy of corticosteroids, intravenous immunoglobulin
Michael D. Dalzell
This month, hospitals and physicians in the second wave of applicants to CMS’s Bundled Payments for Care Improvement Advanced (BPCI-A) model are deciding whether to take the plunge. In late September, CMS provided four years’ worth of claims data to applicants, who have until December 1 to look…
Lola Butcher
America’s health care spending shares some unfortunate attributes with the country’s obesity epidemic: It’s a growing problem, easy to see, and harder to fix than you might think. In 2017, U.S. health expenditures weighed in at $3.49 trillion, or $10,739 per capita. That works out to 17.9% of…
P.C. Vey
P.C. Vey is a regular contributor to the New Yorker, and his work has been published in Harvard Business Review, National Lampoon, Playboy, the Boston Globe, the Wall Street Journal, and the New York Times.
Timothy Kelley
C​ould drug prices be lowered by pegging them to what is paid in other countries? The Trump administration took a step in that direction last fall, when CMS floated a proposal to use international reference pricing (IRP)—average prices paid in a select group of other high-income nations—to limit…
CURRENT ISSUE November 2019

The 10 Most Important Numbers in American Health Care

Remember paint by the numbers. It rewarded staying in the lines, not insight or creativity.

But in this issue of Managed Care, we are not painting by the numbers. We are painting the portraits of numbers with nuance, shading, and some perspective

Facts, figures, statistics, tallies—they can be sterile enumerations. But behind each is a story: of resources, pinched and expanded; of decisions that beget other decisions that beget still more decisions; of competing interests, the winners and losers. And this is health care, so the pain and suffering that illness can bring.

In our gallery: the $3.49 trillion in annual health expenditures, the $20,576 in premium costs that will provide family coverage, the 747 in health care private equity deals. And there are seven others.

We’d like make a confession. Our title might have hedged it a little by, say, putting it as “10 of the Most Important Numbers in American Health Care.” Because there are many issues we haven’t touched upon: racial disparity, consolidation of payers and providers, wasteful health care spending.

So there’s room for more exhibitions.

In the meantime, enjoy—and learn—from this one

Payers' Playbook
Joseph Burns
A Rand report showing that some hospitals charge 200% to 300% more than Medicare pays has sparked a new effort among employers to push hospitals to cut what they charge for care. Hospital leaders say price is only part of the story.
Legislation and Regulation
Richard Mark Kirkner
They’ve marshalled forces and pushed back on legislative efforts to curb exemptions, although three states have managed to do so.
Feature
Susan Ladika
Insurers say opening up clinics in drugstores will make health care more convenient, more timely—and potentially less costly. But will it also bring unwanted commercialization and fragmentation?
Feature
Lola Butcher
Instead of retrofitting for the new world of “value,” what would it be like if a brand-new medical school and health system were built with that mindset from the start? Clay Johnston, MD, and his colleagues in Austin are finding out.

A blueprint for high-volume, high-quality lung cancer screening that is detecting cancer earlier—and helping to save lives

Clinical Brief

Multiple Sclerosis: New Perspectives on the Patient Journey–2019 Update
Summary of an Actuarial Analysis and Report