Health Care Cost

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).

The Trump administration finalized rules aimed at making health care pricing more visible and transparent to those with with health insurance from employers or the individual market.

At the Alliance for Better Health’s CONVERGE Virtual Conference, experts discussed the role social determinants of health (SDOH) play in community-based health initiatives.

Study results demonstrate the multimillion-dollar savings achieved among patients with heart failure with reduced ejection fraction (HFrEF) following treatment initiation with sacubitril and valsartan.

The decision to go on dialysis is often automatic, but using a shared decision-making process reduces the chance that a patient will regret it later.

Heart failure with reduced ejection fraction (HFrEF) is when the heart’s left ventricle can only pump out 40% or less of the blood it contains, resulting in less oxygen-rich blood being disseminated to the body than it actually needs.

2020 is the 25th anniversary of The American Journal of Managed Care® and the October’s issue of the journal features an interview with Dr Kavita Patel, a nonresident fellow at the Brookings Institution and a primary care physician.

Challenges remain, in light of new guidelines, when making treatment decisions for patients with severe asthma, noted Megan Althoff, MD, PhD, second year fellow, University of Colorado, Division of Pulmonary Sciences and Critical Care Medicine.

Marty Makary, MD, MPH, kicked off the Academy of Managed Care Pharmacy Nexus 2020 meeting with a call to action around reducing overprescribing, increasing price transparency, and recapturing the public’s trust in the health care system.

Attendees at the Academy of Managed Care Pharmacy (AMCP) Nexus 2020 meeting will hear a keynote from a surgeon who has become more visible over the past year and a half discussing what he says are “structural problems” behind the cost of US health care.

The authors, from RxCrossroads by McKesson, discuss the impact of copay accumulator and maximizer programs.

Newly published data suggests most patients are opting for second- or third-generation tyrosine kinase inhibitors instead of a generic form of imatinib.

Orphan drug spending to treat rare conditions in children is increasingly burdening payers and families, a recent study said.

Family premiums for employer-sponsored health insurance rose 4% over the past year, averaging $21,342, according to Kaiser Family Foundation (KFF) study findings, with workers contributing $5588 in out-of-pocket costs.

Two neurologists discuss what is known and unknown in switching patients with migraine from one calcitonin gene-related peptide (CGRP) inhibitor to another.

A House panel found pharmaceutical companies exponentially increased drug prices to boost profits; CDC data show an increase in alcohol-related deaths, especially among women; 4 million more Americans enroll in Medicaid.

Speakers at Patient-Centered Oncology Care® highlighted injustices in the US health care system, the risk of financial toxicity, and how providers can do a better job to ensure their patients achieve health equity, during a panel discussion.

The survey was released to mark Pain Awareness Month.

A cost-saving provision made possible by the recent COVID-19 relief CARES Act now allows Americans to leverage pre-tax funds from their flexible spending arrangements [FSAs] or health savings accounts [HSAs] to purchase over-the-counter medicines and menstrual care products.

Sickle cell disease is a costly disease for patients, but when those patients suffer from end-organ damage, the costs jump significantly.

A decision-analytic model could save more than $7 million in overall ineffective health care costs per 1000 patients by predicting which patients with rheumatoid arthritis (RA) will have an inadequate response to anti–tumor necrosis factor therapies.

Patients with spinal muscular atrophy (SMA) incur significant health care resource utilization and cost burden, particularly those with infantile-onset SMA.