“It’s 907 pages long, with 70,000 pages of regulations — and it’s not done!” says health care lawyer Craig Garner. Here are some of the main stumbling blocks, and suggestions for how to avoid them. Meanwhile, the clock is running; full implementation approaches.
The director of the newly established Johns Hopkins Center for Population Health Information Technology talks about his efforts to bring more accountability into the system. He believes that information technology can help create outcomes measurements that are more detailed.
Many health plans have long encouraged this move even before the U.S. Preventive Services Task Force made its recent ruling. However, the mandate lacks specificity regarding how often not-at-risk patients should be screened. Also, physician buy-in is crucial.
There’s a general framework, even though details may vary according to the goals and capabilities of provider organizations. Commercial payers don’t always have to wait for the fine print to know if a proposed ACO is workable.
Insurers often do not know what they are paying for because different tests are billed with the same code, but help may be on the way. A new map reference product with Z-Code Identifiers and CPT codes could be available next year.
Established players vie with upstarts in jockeying for approval by the Food and Drug Administration. The term “breakthrough therapy” is tossed about, but neither manufacturers nor payers really know what value the tag carries.
Which means that overall drug spending for 2012 increased by just 2.7%. The dark cloud in the silver lining is that specialty-drug spending increased more than 18%. That’s the biggest increase for that category since 2004.
Lora M. Pellegrini
A special panel hopes to push providers toward a global payment system that focuses more on outcomes
A summary of ECRI Institute’s Emerging Technology Evidence Report
Studies suggest that U.S. physicians are hesitant to put patients on insulin therapy, but these pens may offer value by improving control
With a third oral therapy for multiple sclerosis, clinicians now have more choices to manage the devastating symptoms of the disease