Reimbursement

Contributor: Implementing Pharmacy-Led Telehealth Strategies to Help Medicare Advantage SNPs Improve Care for Older Adults Amid COVID-19 and Beyond

January 24th 2021, 1:00pm

Pharmacy-led telehealth strategies will position Special Needs Plans (SNPs) for Star Ratings success during the pandemic and for years to come.

Amy Ellis Discusses Choosing Between Multiple Oncology APMs

January 20th 2021, 2:00pm

Video

With so many different oncology alternative payment models (APMs) available, choosing the right ones to participate in might simply mean finding which ones already align with what a practice is doing, said Amy Ellis, chief quality officer at Northwest Medical Specialties.

Payer Implications on Reforms to Price Transparency

January 17th 2021, 6:43pm

Video

Amid recent reforms on price transparency by CMS and the Trump administration, payers' workloads will substantially increase with notable challenges that include having to maintain accurate prices and the impact of exposed negotiated rates.

Multiple Factors Hinder Uptake of Monoclonal Antibody Therapeutics for COVID-19

January 14th 2021, 9:33pm

Article

The US Surgeon General, Vice Admiral Jerome Adams, MD, and other officials urged for greater uptake of FDA-approved treatments for coronavirus disease 2019 (COVID-19) in an effort to slow the surge of cases requiring hospitalization. However, logistic, monetary, and efficacy concerns may have drastically limited the amount of biologic treatments actually administered to patients.

Endocrine Society Calls for Negotiated Insulin Prices in Medicare

January 13th 2021, 9:17pm

Article

The statement is aimed at drug companies, policymakers, pharmacy benefit managers, employers, and others, and calls to attention soaring insulin costs, which were the subject of several Congressional hearings in 2019.

Dr Barbara McAneny Voices Concern for the Future of Payment Reform

January 11th 2021, 6:45pm

Video

Barbara McAneny, MD, founding partner of New Mexico Oncology Hematology Consultants, discusses why putting risk on oncologists is not the way to fix cost issues in cancer care.

What We’re Reading: Pediatric Mental Health; Study on Cognitive Decline, COVID-19 Link; UnitedHealth to Acquire Change Healthcare

January 6th 2021, 3:29pm

Article

The coronavirus disease 2019 (COVID-19) pandemic disrupted many mental health services for children; a study on the long-term effects of COVID-19 will soon kick off; a $13-billion deal has been struck for UnitedHealth to buy Change Healthcare.

Dr Sibel Blau Highlights Reimbursement Concerns in Oncology

January 5th 2021, 2:00pm

Video

The economics of cancer care remain a major concern as practices try to figure out how to deal with the cost of providing cancer care, said Sibel Blau, MD, medical oncologist, Northwest Medical Specialties, and president and CEO, Quality Cancer Care Alliance (QCCA).

Dr Barbara McAneny on the Pitfalls of Bundled Payment Plans

December 29th 2020, 3:00pm

Video

Barbara McAneny, MD, CEO of New Mexico Oncology Hematology Consultants, gives her insight on the potential pitfalls of bundled payment plans in oncology and how they could potentially work.

Dr Basit Chaudhry: Commercial Payers Are Expected to Start Aligning More With Medicare

December 26th 2020, 2:30pm

Video

There is a lot of variation among commercial payers, but broadly speaking they are expected to start moving to adopt what Medicare does, said Basit Chaudhry, MD, PhD, founder of Tuple Health.