Health Care Cost

Robert Baird, RN, MSA, president of the National Cancer Treatment Alliance, discusses ways that employers of all sizes can pursue direct contracting with health care providers.

Recent study findings highlight mixed results following use of this medication among Mississippi and Massachusetts Medicaid beneficiaries.

In addition to significant morbidity and impaired health-related quality of life, patients with atopic dermatitis have a significant out-of-pocket (OOP) financial burden related to their disease.

Robert Baird, RN, MSA, president of the National Cancer Treatment Alliance, discusses potential issues employers can avoid by direct contracting with providers.

The use of Mohs micrographic surgery, which had the highest average Medicare payment from 2012-2017 among a set of 4 skin cancer procedures, has increased by more than 20%.

Bradley Monk, MD, FACOG, FACS, clinician at Arizona Oncology, professor at the University of Arizona and Creighton University in Phoenix, discusses the reimbursement of PARP inhibitors in ovarian cancer.

Four principal themes emerged in this study, describing why Latino/a and Black transgender women and men who have sex with men discontinued their preexposure prophylaxis (PrEP) to prevent HIV.

An outcomes-based agreement conducted by Boehringer Ingelheim and Highmark found that use of Jardiance (empagliflozin) among adults with type 2 diabetes (T2D) and known cardiovascular disease (CVD) was associated with a total cost of care savings of over 20%.

The German multiple sclerosis (MS) study found differences by gender for some costs, but the overall economic burden of the disease was about the same.

In its 2021 Hospital Outpatient Prospective Payment Final Rule, CMS announced it will delay its radiation oncology payment model from January 2020 until July 2021.

A funding dispute over how to account for a Veterans Affairs (VA) health care program is stalling deal to fund the government for another year; the Supreme Court rules in a case involving states and pharmacy benefit managers (PBMs); the antiepileptic drug ezogabine lowered the pathologic excitability of cortical and spinal motor neuron cells, which have a role in amyotrophic lateral sclerosis (ALS).

Results from a 5-year study show significantly higher rates of several gastrointestinal (GI) disorders, as well as hospital-related costs, among patients living with HIV compared with controls.

The United States reports a record 3000 daily coronavirus disease 2019 (COVID-19) deaths; the House of Representatives passes bill in support of marijuana research; data show rises in prescription drug list prices.

This episode of Managed Care Cast is a preview of an interview with Michael E. Chernew, PhD, and A. Mark Fendrick, MD, the co-editors-in-chief of The American Journal of Managed Care®, which appears in the December issue of the journal.

Among 11 developed countries, the United States has the highest maternal mortality rate, a relative undersupply of maternity care providers, and no guaranteed access to provider home visits or paid parental leave in the postpartum period, a recent report from The Commonwealth Fund concluded.

A review found that including exercise, breathing techniques, and education components in pulmonary rehabilitation for patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) optimizes such programs.

An analysis published in Health Affairs outlines the benefits of structuring negotiations and standardizing fee-for-service payments independent of any specific reform proposals to control health care spending in 3 high-income countries.

A new report finds including rituximab in first-line therapy for diffuse large B-cell lymphoma (DLBCL) results in better overall outcomes that more than offset the higher initial cost of therapy.

President Donald Trump issued 2 orders Friday aiming to lower drug prices paid by Medicare by invoking a "most favored nations" policy and also by targeting rebates paid to pharmacy benefit managers.

Although half of US rheumatologists have patients for which nonmedical switching has been suggested, only 35% were likely to switch patients with rheumatoid arthritis doing well on a reference product to a biosimilar.

Which types of comorbidities have the greatest impact on direct and indirect costs of multiple sclerosis (MS) over time?

A multidisciplinary spine intervention can reduce chronic back pain–related health care utilization and costs, according to a study published in Spine.

During a webinar, experts discussed where health care has improved life expectancy and the relationship between cost and relative contribution that each area makes to life improvement and expectancy.

During oral arguments, the justices asked skeptical questions regarding Republican state efforts to get the Affordable Care Act (ACA) overturned.

Overuse of reliever inhalers among adult patients with asthma is prevalent, but does not necessarily translate into higher all-cause health care utilization (HCU), according to a study published in Scientific Reports.

A group of patient advocacy organizations released their 100-day agenda for the next president.

There is a lot of uncertainty among providers participating in federal alternative payment models (APMs) given the general election and the upcoming Supreme Court case on the Affordable Care Act (ACA).

As novel therapies drive up the cost of cancer care, federal policy decisions are being made that influence oncologists' ability to deliver cancer care, said Debra Patt, MD, PhD, MBA, MPH, of Texas Oncology.

The American College of Rheumatology (ACR) has joined forces with other provider groups to oppose a plan proposed by UnitedHealthcare that would increase patients’ out-of-pocket costs.

This week, CMS proposed changes to the Medicare Durable Medical Equipment Prosthetics, Orthic Devices and Supplies (DMEPOS) coverage and payment policies which would expand Medicare coverage for continuous glucose monitors (CGMs).