Something interesting is going on in Camden, N.J., and other places in the country. Providers give the most vulnerable greater access to primary care, efforts that include sending nurses out to knock on doors. Anecdotal evidence so far, but there may well be huge savings resulting from such efforts.
“I am definitely excited about where primary care is going,” says the founding dean of the Jefferson School of Population Health, and the Dr. Raymond C. and Doris N. Grandon Professor of Health Policy at Thomas Jefferson University. Here he speaks with John Marcille, editor of Managed Care, and Sonja Sherritze, editor of P&T, about what drives his enthusiasm.
Instead money is being put into systems that heighten the focus on measuring performance. Hasn’t this discussion been going on for decades? Is performance-based measuring really going to happen this time? “I think it has to,” says Paul Ginsburg, PhD, president of the Center for Studying Health System Change.
Qsymia and Belviq can stall the progression of diabetes, but side effects and retail cost of about $200 a month are obstacles to formulary placement. Health insurers are under pressure. Since the American Medical Association labeled obesity a disease, physicians want to extend coverage to more patients.
Many patients leave the hospital no longer needing antidiabetic medications, and that’s good. It’s costly, though, and that’s not so good. Questions remain about its long-term effect on micro- and macrovascular complications, as well as on chronic conditions such as sleep apnea.
Readmissions has been a hot topic ever since the Centers for Medicare and Medicaid Services started fining hospitals when they have too many of them for certain conditions. Researchers want to find out what role medication adherence (or non-adherence) might play but are unable to reach a definitive conclusion.
Consumers expect reasonable premiums and copayments but give health plans grief over a proven cost-control method. How soon we forget.
Management tactic borrowed from traditional pharmacy
Twenty-five years ago we had not even identified the virus that was neither type A nor type B. Now we have slowed its spread and can cure it, at considerable cost.