Payers

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The 2015 joint statement of the American Association of Diabetes Educators, the American Diabetes Association, and the Academy of Nutrition and Dietetics called for diabetes self-management education and support at 4 distinct points: at diagnosis, at annual assessments, when complications arise, and at transitions.

Many payers are incorporating Fitbit technology into healthcare plans as part of both prevention and clinical treatment programs, hoping that it can help members become healthier and more active, according to Ben Sommers, MBA, vice president of North America Business Development at Fitbit Wellness.

In the year since New Jersey regulators approved OMNIA, the state's health insurance market has experienced the same upheaval seen elsewhere: the number of options on the exchanges has shrunk from 5 to 2.

While Mylan has steadily increased the price of EpiPens since 2007, the uproar from consumers is more recent. This suggests that for several years, payers masked the cost of the product, but that has changed with the popularity of high deductible plans.

Payers are making investments in care coordination to halt the overuse of services and medication. Certified diabetes educators (CDEs) are ideal candidates for this role, since so much of high healthcare spending is due to chronic disease.

The growth of clinical pathways in cancer care brings opportunities to improve quality and control cost, but there are frustrations, too. Physicians want to retain some freedom and are pushing back against the administrative jungle from multiple payers, according to a special issue of Evidence-Based Oncology, a publication of The American Journal of Managed Care.

Depending on one's point of view, the 340B prescription drug program keeps safety net hospitals afloat or serves as a profit center at the expensive of community providers. Three leading voices-Rena M. Conti, PhD; Peter B. Bach, MD, MAPP; and Michael Kolodziej, MD; recommend reforms in the new issue of Evidence-Based Oncology, a publication of The American Journal of Managed Care.