A recent study by Rogers et al appeared in Health Affairs, “Interruptions in Private Health Insurance and Outcomes in Adults with Type 1 Diabetes: A Longitudinal Study.” The findings indicated that for those with chronic diseases (Type 1 Diabetes in this case), the loss of insurance exacerbates their condition markers and lowers one’s perceived health and satisfaction with… Read More »
In most industries, technology has been credited with driving innovations and improving the productivity and quality of products and services we utilize every day. Unfortunately, Healthcare has not experienced this same occurrence. There are numerous cutting-edge technologies occurring in healthcare, but one must question if the value of care has progressed? Has technology provided a marked increase in… Read More »
There is a conversation occurring concerning the ability of states to administer specific personal responsibility requirements on Medicaid beneficiaries to receive coverage benefits. This discussion is relevant as it relates to the Medicaid Work Requirements that states are currently proposing. A seemingly simple notion on the surface; recipients must meet specific requirements as a condition of their coverage,… Read More »
In recent blogs, I have discussed the issues and possible innovations concerning the ever-increasing costs of medications and the new payment mechanisms that might improve the situation. The role of the Pharmacy Benefit Manager (PBM) continues to come into question, and the evolution of the industry is much needed. Interestingly, in 2017, the top PBMs had revenues that… Read More »
There is a significant amount of discussion concerning the prices of drugs. For example, the spending on pharmaceutical treatment of cancer has increased $19 billion from 2012 to 2016. Price growth continues, and analysts estimate that by 2021, 25% of all new pharma research will be on cancer treatment and 87% of this growth will be on targeted,… Read More »
As discussed in a previous blog, using true value-based drug pricing will require us to implement an agreed-upon benchmark such as Quality Adjusted Life Years (QALY). The Institute of Clinical and Economic Review (ICER) is an organization that attempts to incorporate qualitative information gathered through public engagement, QALYs, price estimates that may vary with the size of a… Read More »
In continuing our conversation concerning value-based pricing of services, we would be remiss if we neglected to focus on the escalation of drug prices. Even now, treatments exist for various diseases that are swiftly approaching the $1,000,000 mark. With increasingly more of these agents coming to market, we can rapidly discern a time where the cost of our… Read More »
The need for physicians to have focus on not only the delivery of care but also the ever-increasing complexity of running a practice has led to the consolidation of physician practices and increased employment of physicians. Recent legislative changes, including the Quality Payment Program and the drive towards value-based payment models, compound the reasons for the slow demise… Read More »
Investment strategies come in various forms and fashions. But the common thread among them all is the desire to have a balanced portfolio, creating the greatest growth and wealth over time. It is interesting to think about the investment strategies of our health and wellbeing in the same manner. Currently, we heavily invest in certain areas. There is… Read More »
“Population health” is a phrase used with ever-increasing frequency. However, depending on who you might ask, the definition varies. For example, the description of a population for a hospital would be any person that is in a bed. For a physician practice, any person under their care would be more appropriate. And then, for a payor or an… Read More »