SAID, MOD, MARD—Swedish researchers are proposing a new taxonomy for diabetes based on a cluster of factors.
CMS is granting waivers that impose work and other new requirements on some Medicaid beneficiaries. Medicaid managed care plans are wary of the added administrative complexity—and possibly a change in the Medicaid population’s risk profile.
The deadliness of liver cancer is undisputed, but a growing body of data shows that too often, patients, and particularly those who are uninsured or nonwhite, miss out on earlier diagnosis and potentially life-saving surgery.
It’s a must because there is a cost to keeping the underserved that way whether that means funding integrated primary care to help people live healthier lives or footing the bill when people get care in the emergency department.
New guidelines from the American College of Physicians recommend less stringent blood sugar targets for most people with diabetes. Other professional groups think that’s a terrible idea.
The winners among the Part D preferred pharmacy networks are willing to trade lower prescription profit margins for larger market share. CVS pharmacies are preferred in plans that enrolled 8.5 million people in 2018, compared with the fewer than 300,000 people enrolled in CVS retail pharmacies in 2017.
Price transparency mandates are catching on. But they may codify that which hasn’t worked all that well so far.
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.
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%.
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.
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.
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.
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.