JUNE 2019

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.
Risk doesn’t faze companies as much as rising premiums, and stop-loss offers some financial protection from the outliers.
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.