There's been a lot of talk in recent years about consumers taking a more active role in deciding what health services they'll receive, but the issue often turns on whether the public is capable of — or interested in — doing so.

According to a Rand survey for the California HealthCare Foundation, consumers often lack the information needed to make health care decisions. There is an even greater "information deficit" among certain groups of people.

Four thousand Californians were interviewed. Researchers found that 46 percent sometimes or never had the information necessary to make appropriate health care decisions.

In addition, 54 percent of people with less than a high school education and 58 percent who reported themselves to be in fair or poor health said they generally lacked sufficient information to make proper health care choices.

CHCF made several recommendations, including a suggestion that providers teach consumers where to find health information.

One place where patient ignorance often goes unaddressed is at the pharmacy counter, according to the Journal of the American Medical Association. A JAMA study points unequivocally to the pharmacy counter as the most "important and underutilized intervention point" in preventing mistakes in drug interactions.

The study sought to uncover the level of "contraindicated coprescribing by the same physicians and codispensing by the same pharmacies." It found that pharmacies accounted for far more contraindicated medication pairs than prescriptions from the same physicians.

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There’s a lot more going on in health care than mergers (Aetna-Humana, Anthem-Cigna) creating huge players. Hundreds of insurers operate in 50 different states. Self-insured employers, ACA public exchanges, Medicare Advantage, and Medicaid managed care plans crowd an increasingly complex market.

Major health care players are determined to make health information exchanges (HIEs) work. The push toward value-based payment alone almost guarantees that HIEs will be tweaked, poked, prodded, and overhauled until they deliver on their promise. The goal: straight talk from and among tech systems.

They bring a different mindset. They’re willing to work in teams and focus on the sort of evidence-based medicine that can guide health care’s transformation into a system based on value. One question: How well will this new generation of data-driven MDs deal with patients?

The surge of new MS treatments have been for the relapsing-remitting form of the disease. There’s hope for sufferers of a different form of MS. By homing in on CD20-positive B cells, ocrelizumab is able to knock them out and other aberrant B cells circulating in the bloodstream.

A flood of tests have insurers ramping up prior authorization and utilization review. Information overload is a problem. As doctors struggle to keep up, health plans need to get ahead of the development of the technology in order to successfully manage genetic testing appropriately.

Having the data is one thing. Knowing how to use it is another. Applying its computational power to the data, a company called RowdMap puts providers into high-, medium-, and low-value buckets compared with peers in their markets, using specific benchmarks to show why outliers differ from the norm.
Competition among manufacturers, industry consolidation, and capitalization on me-too drugs are cranking up generic and branded drug prices. This increase has compelled PBMs, health plan sponsors, and retail pharmacies to find novel ways to turn a profit, often at the expense of the consumer.
The development of recombinant DNA and other technologies has added a new dimension to care. These medications have revolutionized the treatment of rheumatoid arthritis and many of the other 80 or so autoimmune diseases. But they can be budget busters and have a tricky side effect profile.

Shelley Slade
Vogel, Slade & Goldstein

Hub programs have emerged as a profitable new line of business in the sales and distribution side of the pharmaceutical industry that has got more than its fair share of wheeling and dealing. But they spell trouble if they spark collusion, threaten patients, or waste federal dollars.

More companies are self-insuring—and it’s not just large employers that are striking out on their own. The percentage of employers who fully self-insure increased by 44% in 1999 to 63% in 2015. Self-insurance may give employers more control over benefit packages, and stop-loss protects them against uncapped liability.