Health Care Cost

CMS released a preliminary list of 101 generic drugs for its Medicare $2 Drug List Model, which aims to cap out-of-pocket costs at $2 per month for select medications.

Patients with refractory metastatic colorectal cancer could use trifluridine/tipiracil (TAS-102) plus bevacizumab as a cost effective third line treatment in China but the same was not found in the United States and United Kingdom.

The theme of our inaugural regional Institute for Value-Based Medicine® event in Boston was, “Elevating Value in Cancer Care,” and one of the 4 panel discussions focused on the important contributions of pharmacists and the practice of pharmacy to the oncology space.

Vice President Kamala Harris announced her proposal that would require Medicare to cover costs of long-term home care, which would mark a notable expansion of Medicare.

Recent results from a new diabetes reversal program demonstrate the reliable, sustained benefits of nonpharmacological interventions in the management of diabetes and overall health of patients.

Between 2011 and 2020, the Veterans Health Administration spent $78 billion on health services for veterans also enrolled in Medicare Advantage.

Hereditary breast cancers are caused by germline mutations, which are genetic mutations inherited at conception and so called because they originate in germ cells, those that develop into reproductive cells and become eggs in female individuals and sperm in male individuals.

Economic incentives and patent protections drive development of innovative medications. Drug prices are determined by consumer demand, not production costs. Therefore, governmental regulation risks future investment in research and development.

The Center on Health Equity & Access is dedicated to reducing health care disparities by exploring innovative solutions, policies, and research that advance health equity for diverse populations.

Inpatient hospital care was primarily controlled by 1 or 2 health systems in nearly half of the metropolitan areas in the US in 2022.

A retrospective analysis on newborn screening for spinal muscular atrophy (SMA) provides further evidence for the benefits of early identification and treatment of the disease.

The Supreme Court’s decision, paired with the newest data demonstrating the public impact of the opioid crisis, illustrates the legal potential in addressing the crisis and the ongoing public health challenges of treatment access.

The company announced layoffs due to business challenges and regulatory pressures.

Average Medicare drug premiums for older Americans will drop next year for those enrolled in traditional Medicare plans or who have coverage through Medicare Advantage, with opinions divided along party lines on the economic implications.

The innovative program from the Family Heart Foundation includes being able to order a free test kit for an at-home blood lipid panel and track your results online, as well as the ability to discuss the findings with care navigators and health care providers.

The pharmacist is a critical member of the care team to help manage patients on treatment and contain costs of cancer care, said Kirollos S. Hanna, PharmD, BCPS, BCOP, FACCC, director of pharmacy, Minnesota Oncology.

The Center on Health Equity & Access focuses on addressing disparities in health care access, exploring innovative solutions, policies, and research to improve health equity across diverse populations.

This interview accompanies the fourth podcast in our National Recovery Month series with Amy Herschell, PhD, associate vice president, Program Implementation and Evaluation, Community Care Behavioral Health Organization, part of the UPMC Insurance Services Division, and Jessica Meyers, MSEd, senior advisor for implementation, UPMC Center for High-Value Health Care.

Catalyst for Payment Reform (CPR) explores stakeholder perspectives in Florida, Michigan, and Nevada, revealing both the challenges and opportunities states face in reforming health care pricing structures.

Hospitals that better utilized heart failure guideline-directed medical therapy (GDMT) had better patient outcomes, with lower mortality rates and costs.

Health plans would see savings faster if they switched to etranacogene dezaparvovec sooner, the investigators found.

A RAND study explores innovative approaches to alleviate stress, enhance mental health support, and address financial challenges faced by caregivers of military and veteran populations.

Ted Okon, MBA, executive director of the Community Oncology Alliance, spoke with The American Journal of Managed Care® about how the Federal Trade Commission's (FTC) lawsuit against pharmacy benefit managers (PBMs) could affect the future of pharmaceuticals and oncology.

Boarding times in the emergency department (ED) have risen nationally, but the implications for health equity have remained understudied. This study investigated whether prolonged ED boarding contributed to perceived racial discrimination and dissatisfaction with care.

The proposed Medicare High-Value Drug List Model, also known as the Medicare $2 Drug List, could have modestly reduced out-of-pocket costs for 38% of beneficiaries if implemented in 2021.

"As CMMI continues to test new equity adjustments, it is important that changes be grounded in scientific principles with extensive testing and validation to ensure the tightest linkage to social needs and health outcomes for underserved communities across the entire US," authors wrote.

The Center on Health Equity & Access covers news spanning health policy, politics, and clinical research, while featuring interviews with expert insights.

The authors examine how insurer and patient out-of-pocket payments for advanced prostate cancer differ by drug and health plan type and describe the relationship between these payments and utilization.

More than 25 million people lost their Medicaid coverage during the unwinding process conducted by all states following the pandemic.

The US health care system is underperforming despite high spending, and reform is needed in areas like insurance coverage, primary care, and equity to improve overall health outcomes and efficiency.