The need for real-time data in health care is universal, but it is particularly pressing for post-acute providers, who are now joining their hospital and health system peers in being held responsible for patient outcomes. CMS is watching.
The need for real-time data in health care is universal, but it is particularly pressing for post-acute providers, who are now joining their hospital and health system peers in being held responsible for patient outcomes. CMS is watching.
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.
As of November 2018, there were 8,774 such centers in the U.S, up 8% from 8,125 in 2017, according to the Urgent Care Association. And although they are not exclusively for people with insurance, just under half (47%) of the patients seen in urgent care centers are covered by commercial insurance.
A study designed to test whether eliminating copays would improve adherence to antiplatelet therapy showed that, yes, indeed, it does. But the results also showed no reduction in major cardiovascular events among those who stuck with the medication.
UPMC Health Plan gets a discount if a patient on Brilinta has a heart attack or stroke. The novel sweetener is that UPMC will lower the monthly copay for Brilinta from $45 to $10, which means the patient cost will be about the same as it is for generic Plavix.
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 stakeholders benefit from the present confusion.
CMS wants Medicare Advantage plans to provide enrollees with immediate access to their health information starting in 2020. But you can't always get what you want. Insurers are especially worried about programming interface software that will allow their databases to share information with third parties, such as mobile apps.
PBMs can play an important role in the pharmaceutical supply chain and are positioned to protect consumers and save them out-of-pocket costs. The emergence of new PBMs, whether inside or outside an insurer, should drive new solutions and the development of new models.
Effective treatment has helped curb the epidemic, but practical cures have been elusive. Now being tested: a "sterilizing cure" that eradicates HIV from the body, and a "functional cure" that effectively reduces the viral load so it cannot be transmitted or progress to AIDS.
It seems that under HHS Secretary Alex Azar, the Center for Medicare and Medicaid Innovation-that ACA-enabled office given almost carte-blanche authority to experiment with new payment and care models-may be getting its groove back. Adam Boehler, hired last April as CMMI director, has cranked up output with a flurry of new models.
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