Health Care Cost

Melissa Levine, MD, a family medicine specialist at Arizona Community Physicians and medical director for the Abacus Health accountable care organization (ACO), discussed strategies for succeeding in an ACO and how primary care can complement oncology care for patients with cancer.

This comprehensive comparative analysis examined the economic and health care resource utilization implications of initiating glucocorticoid and exon-skipping therapy for Duchenne muscular dystrophy (DMD).

Ted Okon, MBA, executive director, Community Oncology Alliance, discusses early returns from the Enhancing Oncology Model and how community oncology practices are innovating in ways that can expand into other areas of medicine.

The study indicated the potential of preventative drug lists (PDLs) as a strategy for those who have high deductible health plans to address both patient access and affordability of asthma care.

FluMist Quadrivalent could become the first self-administered flu vaccine in the United States; the American Society of Reproductive Medicine updates its definition of infertility to be more inclusive; the Environmental Protection Agency moves to ban the use of a cancer-causing chemical .

At the 2023 COA Payer Exchange Summit being held October 23-24 in Reston, Virginia, Lalan Wilfong, MD, US Oncology Network, emphasizes the importance of oncology care equity, ensuring continuity of care, and enhancing care coordination.

Medicare Advantage (MA) plans pose financial challenges for small rural hospitals; 2 bans proposed in Texas would prohibit transportation for abortion procedures; delays in reauthorizing US President's Emergency Plan for AIDS Relief (PEPFAR) risk the program’s effectiveness and integrity.

This analysis demonstrates value and innovation of direct-acting antivirals for the treatment of chronic hepatitis C in the US Kaiser Permanente health system.

Study investigators note their meta-analysis may be the first to demonstrate the importance of interventions to support adherence to adjuvant endocrine therapy for breast cancer.

A 5-year randomized trial showed that the Million Hearts Model, which paid health care organizations to monitor and reduce cardiovascular disease (CVD) risk, was effective in reducing first-time heart attacks and strokes without associated increases in Medicare spending.

Monica Bertagnolli, MD, fielded questions on hot-button issues during the long-delayed Senate hearing on her nomination to head the National Institutes of Health; Pfizer announces the list price for a 5-day course of its COVID-19 antiviral, nirmatrelvir/ritonavir (Paxlovid); a federal initiative is distributing funds to programs aiming to prevent drug overdoses in pregnant women.

During a session at AMCP Nexus, panelists provided a historical overview on the 340B drug discount program, highlighting the intentions of the plan and the research gaps leading to misconceptions about the program and whether it’s working to lower costs for patients.

In the aftermath of the Dobbs v Jackson Women’s Health Organization ruling, Anita Allen, PhD, highlights the challenges to abortion rights in the United States, emphasizing disparities faced by marginalized communities, outlining threats to reproductive health care, and calling for collective action and advocacy to defend constitutional privacy and uphold the dignity of all individuals.

Amazon Prime air service is testing delivery of medication within an hour or ordering; Surging insurance costs are affecting 150 million Americans; Opponents of President Joe Biden's mental health care proposal argue potential rules could hinder access to quality care.

To ensure patients are getting timely access to their treatments, there needs to be better collaboration between payers and providers, said Christine Pfaff, RPh, senior regional director of operations, American Oncology Network.

Two posters presented at the American Society for Reproductive Medicine (ASRM) 2023 Scientific Congress & Expo showed trends in funding and insurance coverage for individuals seeking fertility care.

A 2022 yearlong initiative at Summa Health Cancer Institute saw 100% of its patients with head and neck cancer undergoing radiation treatment referred to an oncology dietician for nutritional support and/or speech and swallow therapy.

Non–guideline-concordant care for ovarian cancer was associated with higher all-cause and cancer-specific mortality, increased health care utilization, and increased Medicare expenditures, highlighting opportunities for improving cancer care in this vulnerable group.

Medicare Advantage star ratings reveal shifts in plan quality and performance; Rite Aid seeks debt reduction and restructures amid financial challenges; workers secure improved wages and staffing

Biosimilars are becoming more common as more launch on the market in the United States, but patient and provider education can help speed uptake of these products, explained Bincy Abraham, MD, Houston Methodist – Weill Cornell.

Older patients often face financial challenges on fixed incomes with different payer systems like Medicare, Sarah Wall, MD, The Ohio State University Comprehensive Cancer Center, says. Accessing treatment centers far away is difficult due to support system disruptions, leading to increased stress and financial strain.

According to the National Cancer Institute, in the year following a cancer diagnosis, the average cost of medical care plus medication exceeds $42,000, with some treatments having a price tag of more than $1 million.

Modest spending on integrated mental health services in primary care, facilitated by use of new collaborative care billing codes, did not increase overall health care costs.

Director Takiyah Durham, MBA, and Margaret Larkins-Pettigrew, MD, share how the program is improving maternal and infant care in Pittsburgh, PA, at Highmark Health.

Fabric Health is transforming laundry time into an opportunity for community well-being, engaging families in laundromats to address health needs and connecting them with health care experts and needed social services. Adaptable and problem-solving oriented, the social-impact startup helps to bridge pandemic-exacerbated disparities by meeting people where they are, fostering health equity.

Jennifer Vaughn, MD, discusses how value-based care in hematology should consider cost and financial toxicity, as well as valuable patient experience.

COVID-19 health care costs are significantly greater than those for influenza and pneumonia. Treatment costs for severe COVID-19 exceed those for influenza and pneumonia by approximately $50,000.

A commentary questions the characterization of cryoprecipitate, which is not pathogen-reduced, as an alternative modality for treating hemophilia, despite its substantial risk of transmitting blood-borne pathogens to patients.

For patients who had 12 months of continuous health care coverage before and after receiving a diagnosis of vitiligo, treatment rates were at suboptimal levels.

In this analysis of more than 97 million commercially insured individuals, investigators found that the COVID-19 pandemic induced a spending shock in 2020 and that health care spending did not recover to baseline until mid-2021.