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.
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.
Employers and health insurers are asking consumers to put ‘more skin in the game’ with high-deductible health plans but don’t provide incentives for them to choose high-value 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.
An age/sex/gene expression score helped to identify patients with low current likelihood of obstructive coronary artery disease. These patients had lower costs of CAD care during one year of follow-up. Early reductions in cardiac referrals at 45 days among these patients persisted for one year.
A federal bill would expand access to experimental treatments, but critics say right to try would take away FDA oversight and create a ‘Wild West.’ Meanwhile, most states’ right-to-try laws have gone unused.
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.
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.
It is finally starting to happen. The first gene therapy to treat an inherited disease is out of the gate. But my, that price tag: $850,000. Many more gene therapies are on their way. How can they be priced to hit the sweet spot of affordability, access, and innovation? Outcomes-based pricing doesn’t really do the trick.
They take the brakes off the immune system so it attacks cancer cells. But many people don’t respond to checkpoint inhibitors, so researchers are looking for ways to defeat the resistance.
At last count, the pharmaceutical industry’s new product pipeline included more than 7,000 products in late-stage development, roughly half of which are deemed “specialty.” The reality is, our health care system is poorly equipped to address this issue head-on.
Cancer survivors were better able to afford care and did not see delays in treatment from 2010 through 2016, the years when the ACA was phased in. But researchers were unable to make a definite connection because many of the ACA’s coverage changes did not come about until January 2014.
Thirty-nine states had contracts with comprehensive risk-based Medicaid managed care organizations and in 29 of those states, 75% or more of the Medicaid beneficiaries were enrolled in one of those organizations. A large majority (27 of 32) of the Medicaid expansion states used managed care organizations to cover newly eligibly adults.