Members of Blue Cross and Blue Shield companies and privately-held health plans tend to rate their overall service experience notably higher than enrollees of non-Blue plans owned by publicly-traded companies, says new study by J.D. Power and Associates. The study asked 10,522 members of large commercial health plans to rank the performance of 49 large health plan companies in the Northeast, South, Midwest, and West. Leading the regions were Harvard Pilgrim Health Care in the Northeast; BlueCross and BlueShield of Florida in the South; BlueCross and BlueShield of Minnesota in the Midwest; and Premera Blue Cross in the West.... More employers are offering consumer-directed health plans (CDHPs), according to a survey by Watson Wyatt Worldwide and the National Business Group on Health. Employers offering CDHPs increased from 33 percent to 38 percent in the last year. Forty percent of employers now offer or plan to offer a health savings account, and 26 percent offer or plan to offer a health reimbursement account.... Using low-dose computed tomography (CT) to screen smokers for lung cancer may increase the rate of lung cancer diagnosis and treatment, but may not reduce the risk of advanced lung cancer or death. Researchers at Memorial Sloan-Kettering Cancer Center conducted a longitudinal analysis of 3,246 asymptomatic current or former smokers who were screened for lung cancer beginning in 1998. They concluded that until more definitive data are available, asymptomatic individuals should not be screened outside of clinical research studies that have a reasonable likelihood of further clarifying the potential benefits and risks.
House Republicans come out with their ACA alternative. A continuous coverage surcharge replaces the individual mandate. But where’s the CBO score?
The biosimilar segment of the pharmaceutical industry is on fire. Some 700 biosimilars are at some stage of development, and more than 660 companies are involved in some way in the biosimilars land rush. Still, only a handful may get on the market in the next few years.
No one knows how much of an effect biosimilars will have on oncology expenditures. Pricing and market share are in a large, opaque “to be determined” cloud. But there’s certainly potential for a major impact that could lower oncology expenditures by millions, if not billions.
The future of biosimilars in this country is nothing if not uncertain. Most immediately, the U.S. Supreme Court is hearing a case that will determine the timing of the 180-day waiting period before a biosimilar can go on the market. But there are larger and longer-term issues at play as well.
While coupons help individual consumers, they are also having a major impact on the insurance industry and anyone responsible for paying health care bills. Insurers and pharmacy benefit managers complain that they foil formularies and other pricing strategies designed to steer consumers to less-expensive drugs.
The hard truth is that telehealth’s future—its size, its contours—will depend a lot on what payers will be willing to pay for. Currently, commercial plans cover only a limited number of services. In addition, research suggests that there may be quality and utilization problems.
Insurers should consider covering new drug-delivery devices that can improve outcomes while lowering disease-specific pharmacy and long-term overall health care costs. Managing these devices in the pharmacy benefit will consolidate volume-based purchasing and capitalize on PBM strategies for improving adherence.
Basaglar is coming on the scene during tumultuous times for insulin products. Manufacturers are under attack for price hikes. There are allegations of backroom rebate deals. And a class-action lawsuit has been brought on behalf of uninsured patients, charging insulin makers with setting artificially high prices.
Evaluating the quality of telemedicine care is about as easy as evaluating the quality of health care, period, and researchers are still ironing out the methodological kinks. That may be one reason research results are all over the place. This article involved reviewing nine such studies, and the findings are a mixed bag.
If millions of Americans lose Medicaid or private health insurance coverage because of the unACAing of American health care, telehealth may seem like a gimmicky sideshow rather than a good-faith effort to bring health care into the digital century.