Aetna Sees Promise in New Heart Disease Diagnostic
With spending on diagnostics alone for cardiovascular disease likely to be a major challenge for insurers amid the baby boom wave, Aetna is turning to an emerging option as part of a strategy to avoid invasive tests and treatments.
What’s in a Name? FDA Urged Not to Give Biosimilars Unique Names
This week, a coalition of 32 major pharmacies, health insurers, unions and pension plans asked the FDA not to require distinct names for biosimilar medications, arguing that such a move would not compromise patient safety, but could undermine the savings that are expected to be generated as these medicines are introduced into the US health care system.
Proposed Rule Would End Sunshine Act's CME Exclusion
The CMS intends to eliminate the exclusion for continuing medical education in the Open Payments program, more commonly known as the Sunshine Act, which requires drug and device companies to disclose payments to physicians.
AJMC Panel Asks: Does It Pay to Use Pathways?
Clinical care pathways in oncology have gained notice with WellPoint’s announcement of a $350 per patient, per month incentive. As WellPoint’s effort starts this week, The American Journal of Managed Care convened a panel with the insurer’s medical director for oncology care, ASCO President Peter Paul Yu, MD, and two other voices from the payer and provider realms to discuss how pathways are changing cancer care.
FDA's Generic-Drug Label Rule Draws Controversy
When new evidence emerges that a brand-name prescription drug has harmed patients, manufacturers are required to immediately warn doctors and consumers by updating product labels or sending letters.
States Test Medicaid ACOs to Cut Costs
Looking to control Medicaid costs, several states are launching accountable care initiatives that mirror experiments underway with Medicare and private insurers but vary significantly in their approaches.
Fee-For-Service Thwarts Value-Based Care's Intention
Society wants the healthcare system to improve the population's overall health while caring for the sick at a lower overall cost. The term of art is providing value-based care. Yet system leaders are stuck with a reimbursement system that still rewards volume through fee-for-service medicine.