August 2015

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Orkambi’s Slick Unveiling Puts Insurers in a Bind

Makers of this expensive new cystic fibrosis medication manage to sidestep controversy. Health plans may not be as lucky as they weigh cost against value.

The search is on for ways to pay for health care that make value more important than volume.

Yes, it failed to uproot the volume and intensity incentives of fee-for-service medicine. But P4P deserves credit for getting the world ready for today’s value-based payment.

Paying for care by the episodes may be the shortest path to value-based care. But administration is tricky, and early results raise questions about the savings achieved.

Of all the “value-based” provider payment methodologies, this one’s the classic. And it may be mounting a comeback.

Without shared risk, shared savings might not be strong enough medicine for what ails American health care.

Ruling in same-sex marriage case extends insurance coverage, but problems with discrimination and lack of access persist.

 

Departments

LEGISLATION & REGULATION

One of the purposes of health care reform was to create more competition, and the recent spate of acquisitions works against that.

MEDICATION MANAGEMENT

This knowledge won’t come cheap, as the system braces for new agents that could add another $42 billion to the nation’s drug bill.

MEDICAL DEVICE MONITOR
TOMORROW’S MEDICINE

The combination of a neprilysin inhibitor and an ARB rescued neprilysin inhibition from obscurity.

MANAGED CARE OUTLOOK

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