Policy

The Congressional Budget Office (CBO) reports that implementation of the Affordable Care Act (ACA) will cost $5 billion less in 2014 than the agency previously estimated. The report further details that an additional 12 million non-elderly Americans will receive coverage this year due to the health law's implementation.

Specialty medications present a challenge for payers as costs for these expensive drugs consume an increasing portion of overall health care spending. In fact, specialty pharmacy spend is expected to rise from $92 billion in 2012 to $235 billion by 2018.

Highlights from recent AJMC conference coverage.

The ASCO task force has identified 3 goals for its strategic value initiative. First is that oncologists will have the skills and tools needed to evaluate the relative value of interventions, and will use these when discussing treatment options with their patients. Second is to have information readily accessible to help patients select high-value treatment that meets their individual needs. Third is to have an algorithm that can be used by those responsible for covering the costs of cancer care to define and assess the value of treatment options.

The American Society of Clinical Oncology (ASCO) has launched a strategic initiative to define value in cancer care.

Healthcare spending rose at the fastest pace in 10 years last quarter, a development that could foreshadow higher costs for consumers this year.

As the quality and cost transparency movements gain support within the healthcare industry, a more important question persists: what will actually work for consumers?

Some health systems are moving beyond surgery in serving back pain patients.

This article reviews the mobile clinic sector's impact on access, quality, and costs, and explores postreform opportunities for leveraging them nationally.

Criminals are stealing patient records to commit medical identity theft. And the Affordable Care Act (ACA) has made the situation worse, according to a new report from privacy and information security research firm Ponemon Institute.

Edmund J. Pezalla, MD, MPH, national medical director, Aetna Pharmacy Management, says Aetna engages consumers in decision-making in a variety of ways.

Just in case Congress doesn't pass President Barack Obama's fiscal 2015 budget plan, officials at the Department of Health and Human Services say they have other options for finding the money they need to implement the health care law.

Lawmakers in Richmond are deep in budget negotiations and will soon decide which parts of the mental health-care system will receive a funding boost.

Some of the same themes being raised across medicine-how to balance the quality of care with soaring therapy costs, and how to unleash the power of genomics to tailor treatment-were part of Saturday's workshop Hot Topics in Pediatric Allergy and Immunology. The session of the American Academy of Pediatrics took place during the 2014 Annual Meeting of the American Academy of Allergy, Asthma & Immunology in San Diego, California.

Although highly touted, the patient-centered medical home model failed to lower use of services or total costs and produced little quality improvement over three years, research has found.

Toby Cosgrove, MD, president and CEO, The Cleveland Clinic, says their organization has implemented a variety of strategies to bend the cost curve.

It's a simple idea, but a radical one. Let people know in advance how much health care will cost them-and whether they can find a better deal somewhere else.

The cost of new hips and knees for privately insured patients varied widely across three dozen hospitals in six states, with hospitals themselves the primary reason, a study shows.

In a rare display of bipartisanship, key committees of both houses of Congress are backing legislation that would permanently erase the sustainable growth-rate formula, a poorly thought out payment reform measure that for more than a decade dictated sharp cuts in Medicare physician pay.

It's a simple idea, but a radical one. Let people know in advance how much health care will cost them-and whether they can find a better deal somewhere else.

It is always important to remember that healthcare and health insurance are two very different things, and neither of them is a guarantee of good health.

While some patients and physicians are not aware of the costs of care, others are concerned about whether they can afford treatment options at all. Dr Miller describes some of the major steps to the incremental benefits and incremental costs incurred by new agents.

Implementing the new ICD-10 procedural and diagnostic codes, which the CMS says must happen by Oct. 1, will be more expensive than previously estimated, according to new research. But costs will vary widely depending on practice circumstances.

Billions of dollars are wasted and thousands of lives lost each year through inefficient or ineffective medication management. It has been estimated that the misuse of prescription drugs in our healthcare system is up to a $300 billion problem annually.

Steven D. Shapiro, MD, executive vice president, chief medical and science officer, University of Pittsburgh Medical Center (UPMC), says that when improving care, sometimes less is more.