They are touted as an alternative to emergency departments. Private companies are seeing an opportunity. But are urgent care centers meeting a demand or creating one?
CAR-T treatments are all the rage and showing some remarkable results. But the high price, along with the lack of long-term results, quiets the optimism.
Recent mergers didn’t quiet the growing frustration and concern employers, pharmacists, consumer advocates, state legislators, and some members of Congress have with the PBMs’ lack of transparency. There are still so many questions, and getting answers anytime soon will be a chore.
It is a heroic part of the American health system. Lives are saved, the dire consequences avoided. But the air ambulance industry is consolidating, prices are soaring, and insurers and providers continually fight over network issues. One consequence: Surprise billing that leaves patients owing tens of thousands of dollars.
The Service Employees International Union Local 32BJ three years ago named Mount Sinai Health System as a preferred provider for participants and started a direct contract for those needing hip and knee replacement surgeries. In health care there are not many examples where each party succeeds. This is one of them.
Too often, the prices of health care services and drugs are cloaked in mystery. A growing consensus demands that patients be given a clearer sense, in advance, of what things will cost. But there are obstacles–and some people benefit from the present confusion.
Unlike most payer–provider relationships, the parties took a go-slow approach. The plan was offered only to employees who worked in a subset of Walmart and Sam’s Club outlets and lived or worked near Emory providers, and Walmart did not set premium levels to incentivize workers to choose the Emory ACO.
Implementation of a new framework would secure RWE’s role in the drug-approval process.
The contract between UPMC Health Plan and AstraZeneca will help the brand-name antiplatelet drug compete against generic versions of Plavix by lowering the copay to $10.
Cigna–HealthSpring and Anthem expand their Medicare Advantage offerings to include such things as hot meals and transportation to providers.
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.
By some counts misdiagnosis leads to up to 80,000 hospital deaths each year—and results in billions in wasted medical spending. Lack of feedback and miscommunication are among the causes. Researchers, advocates, and others are pushing for changes and ‘diagnostic excellence.’
For Medicare for all to truly work for all Americans it must do more than provide uniform, basic insurance. In health care, as in fashion, consumers need different options. To truly reform health care, solutions must allow customization and consumer choice.