- Center on Health Equity and Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Appropriate, Value-Based Care in Immuno-Oncology
The idea of cost of care should be simple, but buying healthcare is incredibly complex, states Andrew L. Pecora, MD. Most individuals do not think about the potential for developing cancer when they make healthcare-related decisions.
Payers have to consider premium costs and risk pools, and generally have to look at their actuarial budgets over 3 to 5 years. In order to make actuarially sound reimbursement decisions, it is important to look at the total cost of care. If a drug is expensive, but changes the natural course of the disease, it provides value, explains Pecora.
There are ways for oncologists to assist patients in getting appropriate coverage for their prescribed regimen. For patients with limited insurance coverage, there are patient-assistance programs. It is important for oncology practices to communicate with payers about their treatment decisions in advance and to ensure these entities that the care is appropriate.
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
Listen
What We’re Reading: FDA Approves UTI Antibiotic; Ozempic, Wegovy Price Investigation; US Births Fall
April 25th 2024The FDA recently approved an antibiotic for the treatment of urinary tract infections (UTIs) in women; a Senate committee recently launched an investigation into the prices of Novo Nordisk’s diabetes and weight loss drugs; US births fell last year, resuming a national slide after a previous increase during the pandemic.
Read More
HOPE-CAT Can Identify Maternal Cardiovascular Risk 2 Months Earlier Than Doctors, Study Says
April 25th 2024In a retrospective study, the machine learning tool was able to screen for potential risks of cardiovascular disease nearly 60 days before the patient's medical record showed any signs of a related condition or before they were officially diagnosed or treated for it.
Read More
