Payers

The frequency with which 7 of the largest Medicare Advantage plans impose step therapy protocols in their Part B drug coverage decisions varies substantially.

Insomnia, along with other sleep disorders, were found to negatively impact workplace productivity.

Enrollment in managed care among Medicaid enrollees presents challenges to classifying Medicaid coverage in cancer registries.

Nathan Walcker, CEO at Florida Cancer Specialists & Research Institute (FCS), highlights some of the recent partnerships and initiatives at FCS to improve community-based oncology care from a value-based perspective.

The playbook includes resources for purchasers to help in their dealings with pharmacy benefit managers (PBMs), including best practice checklists, sample questionnaires for choosing consultants, and recommendations for contracting language.

The Medicare Shared Savings Program (MSSP) generated its second highest annual savings since the program began more than a decade ago.

Biosimilars can improve access to treatment for patients who might not have been able to access biologics previously, explained Laura Wingate, executive vice president, Education, Support, & Advocacy, Crohn's & Colitis Foundation.

The Biden administration has released the first 10 drugs subject to price negotiation with Medicare under the Inflation Reduction Act (IRA), and among those chosen were Stelara (ustekinumab) and Enbrel (etanercept), both of which will face biosimilar competition within the next decade.

Physicians have been facing increasing workloads making it difficult to practice medicine as they were trained, but an accountable care organization might provide an opportunity for real change to deliver high-value, compassionate care.

COVID-19 hospital visits by adolescents nearly doubled; government to release list of drugs Medicare will be able to negotiate prices for; Rite Aid gears up for bankruptcy while facing lawsuits over alleged opioid involvement.

The Biden administration is expected to unveil the first 10 drugs identified for drug price negotiations Tuesday; American nursing homes are disappearing; gender-affirming surgeries tripled in the United States between 2016-2019.

In 2023, the United States was in the midst of the largest drug shortage in a decade, including lifesaving platinum-based medications to treat a variety of cancers.

The revisions to the ACO REACH model are expected to add predictability and stability while advancing health equity.

Coverage from the June 8, 2023, Institute for Value-Based Medicine session in Austin, Texas, held in partnership with Texas Oncology.

The program, which scales an accountable care organization (ACO) model across all major payers in Vermont, reduced Medicare spending and hospitalizations while improving patient care.

Patients were twice as likely to get a colorectal cancer screening and 50% more likely to get a breast cancer screening in their first year of Medicare coverage.

Investigators from China used circulating tumor DNA testing alongside bone marrow assessments to evaluate patients' pretreatment and posttreatment disease levels and to track the course of the disease.

There is a right way and a wrong way to inform a patient about a switch from the reference product to a biosimilar, explained Laura Wingate, executive vice president, Education, Support, & Advocacy, Crohn's & Colitis Foundation.

Coverage of ASCO sessions and posters that addressed lessons from the Oncology Care Model and concerns about the Enhancing Oncology Model, which launched shortly after the annual meeting ended.

Coverage of sessions on disparities in access to clinical trials and cancer screening, as well as relationships each to outcomes. A joint session presented by ASCO and the European Society for Medical Oncology (ESMO) highlighted progress and lingering gaps in lung and colorectal screening.

Presentation of the COMMANDS trial offered practice-changing results for luspatercept.

Physicians and health care groups have lined up to support the Value in Health Care Act, which could create new incentives to adopt value-based care.

The playbook from the 3 organizations highlights 5 best practices for data sharing from organizations with real-world experience in value-based care arrangements.