In Slow Medicine, Victoria Sweet, MD, pulls the reader into a different reality, one that harkens back to an earlier era of one-on-one medicine, when physicians and patients commonly shared a bond of trust and familiarity. That era has faded with the emergence of systems of care and performance targets.
The breast cancer mortality rate in 2012 declined 49% compared with the expected baseline, and 63% of that reduction was from treatment drugs. You’d think that patients would take their cancer medicines no matter what. But when cost sharing reached between $100 and $500, the abandonment rate soared to 32%.
Cut an inch-long incision into someone’s scalp. Then drill a hole into the skull that’s no bigger than a dime. Insert an electrode directly into the brain that targets the reward center, the nucleus accumbens. Then thread a wire beneath the skin to a pacemaker implanted in the patient’s chest. That’s deep brain stimulation.
On the one hand, the PCMH is an admirable effort to gather in one place all the disparate and disorganized clinical and social supports the patient needs. At the same time, though, medical homes employ provider-defined business models and conventional performance measures, belying the patient-centered in the name.
Resource use and exacerbation among patients with COPD are weighed in a preliminary study. Subjects treated with a combination of long-acting muscarinic antagonists (LAMA) and long-acting β2-adrenergic agonists (LABA) cost more to manage than those receiving LAMA alone, although emergency department and outpatient visit costs were less. The authors say those starting the LAMA+LABA therapy may have more severe COPD.
These eight questions show that the use of an LBM or a PAP should be just one of the potential results of your laboratory benefit management program, not the program itself. You shouldn’t have to pay for services you already provide yourselves or add a middleman that’s not necessary.
The CMO of Molina Healthcare of Utah grew up, let’s say, not rich. He says that and a varied background—including a stint in the Air Force—helps him deal with changing policies involving a challenging population.
The number of children ages 1 to 17 admitted to hospitals for an overdose of opioids nearly doubled from 797 patients between 2004 and 2007 and 1,504 between 2012 and 2015. The oldest children in the study in Pediatrics, those between 12 and 17, accounted for over 60% of patients admitted for opioid overdose.
The industry has been criticized for lack of transparency—and worse. Some see ‘a ton of sense’ in the proposed mergers with insurers and retailers. Others see a risk of even higher drug prices and a need for oversight.
It’s no mystery why this country has both the highest per capita health care costs and the lowest overall percentage of people with coverage. The two are connected, but as if on a teeter-tooter: As one goes up, the other goes down.
Diabetes is the scourge of our times, but we have been chasing the wrong culprits. A simple, $40 test of insulin resistance could put us on the right track.
Some hospitals are making house calls these days as they experiment with delivery of high-intensity care in people’s homes. Taking the hospital out of hospitalization might be safer and less expensive than conventional inpatient care. Median direct costs of the home patients were half that (52% lower) of the control patients who received conventional hospital care.
The architects of Medical Episode Spending Allowance benefits are radically reframing coverage as allowances for episodes of care and have a plan for engaging members in making better choices.