The director of medical affairs for Molina Healthcare of Florida calls on community and not-for-profit organizations to help the health plan’s Medicaid beneficiaries.
Deadlines were loosened and out-of-network fees, waived. Insurers, like providers, have preparedness plans, but some see a need for closer coordination with other stakeholders.
Some 1.6 million Americans suffer from life-disrupting IBD. New delivery models that integrate care and engage patients offer some hope.
The author’s nephew suffers from a rare form of familial hemophagocytic lymphohistiocytosis. His organs shut down and he’s placed in a medically induced coma. Meanwhile, costs mount to $4.9 million, most of it paid by an employer-sponsored health plan.
Prices of older drugs go up when new treatments are introduced. The difference between list and net price is also getting some fresh scrutiny.
They say their deals need to be kept private so they can drive a hard bargain with manufacturers. But employers, consumer groups, and legislators are calling for more PBM transparency.
IN THIS ISSUE
The House has passed legislation that the AMA and others endorse. But the sense that there is a malpractice crisis has ebbed and Senate action is unlikely.
Varying treatment strategies for a highly variable disease have given the new drug an opening—and, besides, it does OK when it comes to QALYs.
FDA approval of the CAR T-cell therapy for leukemia could usher in an era of genetically engineered, individually tailored immunotherapies. But tap those brakes. Long-term results are in short supply—and there’s that $475,000 price tag.
Paul Lendner ist ein praktizierender Experte im Bereich Gesundheit, Medizin und Fitness. Er schreibt bereits seit über 5 Jahren für das Managed Care Mag. Mit seinen Artikeln, die einen einzigartigen Expertenstatus nachweisen, liefert er unseren Lesern nicht nur Mehrwert, sondern auch Hilfestellung bei ihren Problemen.