Laura Joszt, MA

Although the country is moving toward value-based payments, for providers it’s basically still a fee-for-service world, said Charles J. Fazio, MD, MS, of HealthPartners Health Plan, at America’s Health Insurance Plans’ Institute & Expo, held June 9-10 in Austin, Texas.

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A new report from CMS has shown that nearly 2 million people who selected an Affordable Care Act health plan on the exchanges did not pay their insurance premium to maintain health coverage just 2 months later.

With the sustainability and affordability of the US healthcare system in dire straits, now is the time for collaboration on new payment models, explained chief executive officers from a health plan and an insurer during a general session on the second day of America’s Health Insurance Plans’ Institute & Expo, held June 7-9 in Austin, Texas.

The United States is only slightly halfway through its healthcare transformation, claimed Mike Leavitt, founder and partner of Leavitt Partners and the former governor of Utah, during a general session on the first day of America’s Health Insurance Plans Institute & Expo, held June 7-9, in Austin, Texas.

During a general session at America’s Health Insurance Plans’ Institute & Expo, held June 7-9 in Austin, Texas, Eric Topol, MD, explained the buzz behind precision medicine and why it is needed to combat the harms of imprecision in medicine.

Bacteria in the gut microbiome is associated with disease progression or delay in patients with metastatic melanoma who were treated with immunotherapy, according to a study presented at the 2017 American Society of Clinical Oncology Annual Meeting.

Healthcare costs for patients with Duchenne muscular dystrophy (DMD) are already far higher than for individuals without the disease, and a new study has found that total healthcare costs are also higher for older patients with DMD.

As Senate Republicans workshop their own healthcare reform bill, they are considering removing the tax exemption for employer-sponsored health insurance plans. Such a proposal would likely face stiff opposition. So what is the exemption and what would be the benefit of removing it?

While statins are primarily used to lower cholesterol, they are also associated with improved heart structure and function, according to research presented at EuroCMR 2017, which was held by the European Society of Cardiology, May 25-27, in Prague, Czech Republic.

Patients with cystic fibrosis face a lifetime of time-consuming treatment. There are new breakthrough therapies that not only treat symptoms of the disease, but also the underlying causes, which represents a source of hope for patients. However, barriers to treatment still stand in the way, according to a new white paper from the Cystic Fibrosis Engagement Network.

The National Heart, Lung, and Blood Institute has released the first-ever COPD National Action Plan, which is aimed at ending the illness.

Although providers might turn to PCSK9 inhibitors to treat patients at risk for atherosclerotic cardiovascular disease or familial hypercholesterolemia for whom statins do not work, the initial denial rate for this therapy can be very high.

A panel discussion on biosimilars at the ISPOR 22nd Annual International Meeting compared the progress in the United States with Europe, which has had a 10-year head start on the market.

Gene therapies have tremendous potential. They are a short treatment that could have lifelong effects. However, the very expensive therapies have a lot of unknowns and raise a number of ethical and practicality questions.

The notion of letting Medicare negotiate drug prices has been around for years, but has recently gained new traction under President Donald Trump. Panelists at the ISPOR 22nd Annual International Meeting, held May 20-24 in Boston, Massachusetts, discussed the complexities of allowing Medicare to negotiate prices and whether or not it would produce meaningful savings.

Is it possible to leverage social networks to influence response to treatment among an untreated population? During the second plenary at the ISPOR 22nd Annual International Meeting, held May 20-24 in Boston, Massachusetts, Nicholas Christakis, MD, PhD, of Yale University, described his research into social network interventions.

Of the payers who have an outcomes-based contract in place, only 9% view them as being very successful, while 50% say they are somewhat successful. Panelists agreed that flexibility is necessary for these contracts to succeed.

Stakeholders’ perspectives can vary, and their different preferences matter when it comes to value assessment, but only if the right questions are being asked.

Healthcare is a complicated issue with few, if any, easy fixes. The important thing is that the country continues to move forward, according to panelists during the first plenary at the ISPOR 22nd Annual International Meeting, held May 20-24 in Boston, Massachusetts.

Following a whistleblower’s assertion that UnitedHealth Group was inflating Medicare diagnoses in order to get more money from the Medicare program, the US Department of Justice has filed a lawsuit alleging the company knowingly inflated risk adjustment payments by making beneficiaries seem sicker than they were.

Medical financial burden has been highest for families in the nongroup market. After the implementation of the Affordable Care Act, the share of families experiencing financial burden declined 6.7 percentage points, Health Affairs study finds.

A new paper in Orphanet Journal of Rare Diseases outlines a new pipeline for identifying opportunities to develop therapies for rare diseases that do not have treatments.

There are conflicting guidelines regarding when to screen cholesterol levels in young adults. A new study aims to clarify at what age asymptomatic individuals should be screened to calculate their elevated risk of developing atherosclerotic cardiovascular disease.

While global inequalities for survival of childhood leukemia have narrowed, the gap remains wide for acute lymphoblastic leukemia and acute myeloid leukemia, according to a study published in The Lancet Haematology. In some countries, the 5-year survival rate is nearly twice as high as in others for children diagnosed in 2005-2009.

The United States healthcare system has to start spending less time fixing people and more time and money on reducing the need to fix them by getting to people earlier, according to panelists who participated in the Brookings Institution’s event “New Directions for Communities: How They Can Boost Neighborhood Health.”

The Senate has confirmed Scott Gottlieb, MD, for the position of FDA Commissioner. Gottlieb faced some criticism from Democrats for his close ties to the pharmaceutical industry, but he promised to recuse himself from any FDA decisions relating to some 20 companies and institutions for 1 year.

A day after House Republicans voted to pass legislation that repeals and replaces large parts of the Affordable Care Act, Avik Roy, Forbes opinion editor and president of the Foundation for Research on Equal Opportunity, outlined what Republicans are trying to fix. After his presentation, he joined a panel discussion on what impact the American Health Care Act will have.

Panelists on day 1 of the ACO & Emerging Healthcare Delivery Coalition® discussed the challenging work of creating public-private partnerships, and how these initiatives can address issues to improve the health of a population.

Patients with irritable bowel syndrome with diarrhea (IBS-D) incur significantly more healthcare costs than matched controls. A new study in the Journal of Managed Care & Specialty Pharmacy found that the extra costs were associated with an increased use of medical services.