Starting a health plan is difficult and success is certainly not guaranteed. Of three 2014 start-up health plans in New York City, Health Republic closed in 2015 and CareConnect closed on New Year’s Eve 2017. Only Oscar remains, and it racked up cumulative losses of $235 million from 2014 to 2016.
Real-world data challenge assumptions regarding typical factor usage and expenditures associated with product switching in patients with hemophilia A. There were higher expenditures over two years on hemophilia A patients using extended half-life (EHL) versus standard half-life (SHL) products.
Asthma is a common chronic respiratory disease affecting nearly 8% of the U.S. population. Fractional exhaled nitric oxide (FeNO) is a noninvasive biomarker for T2-driven (i.e., allergic) airway inflammation that could be used to improve diagnosis, optimize inhaled corticosteroid dosing, and monitor adherence.
Current asthma guidelines combine treatment, follow-up, and re-evaluation to manage asthma control, reduce impairment, and decrease risk of morbidity in patients. Analysis reveals that FeNO monitoring to guide asthma management is cost effective, increasing quality-adjusted life years while decreasing costs associated with asthma management.
An age/sex/gene expression score helped to identify patients with low current likelihood of obstructive coronary artery disease. These patients had lower costs of CAD care during one year of follow-up. Early reductions in cardiac referrals at 45 days among these patients persisted for one year.
ACOs need to provide comprehensive care management across a spectrum of provider specialties. To do this, they need a framework for evaluating potential partners that will help risk-bearing providers establish the partnerships that will enable them to achieve their goals.
As expected, pharmacy costs increased with the introduction of this new treatment in a market dominated by over-the-counter and generic treatments. On the other hand, outpatient GI-related and irritable bowel disease health care resource use and costs substantially decreased among commercial and Medicare patients following linaclotide treatment initiation.
The document “Feature and Function Recommendations To Optimize Clinician Usability of Direct Interoperability To Enhance Patient Care” offers recommendations from the clinician point of view. Widespread adoption of even a few of these recommendations by designers and vendors would greatly enhance care.