Insurers and pharmaceutical companies want ICER to umpire debates about drug prices. But some question the cost-effectiveness calculations of the Boston not-for-profit and its dependence on QALYs.
When patients and their medical records are out of whack, it causes harm and wastes money. American attitudes about privacy—and the multitude of competing provider organizations—makes the patient matching problem hard to fix.
The American College of Emergency Physicians has proposed a payment model that would have ED physicians tracking patients for 30 days after discharge. CMS is mulling it over.
A newspaper series and a state audit put a spotlight on PBM practices in Ohio. Congress and other states are also looking more closely at what PBMs are delivering to Medicaid health plans.
Perinatal quality collaboratives and other responses may help reverse the trend. But payment reform that gets rid of perverse incentives is a prerequisite.
