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CVS and the $100,000 QALY. CVS和10万美元的QALY。
Managed Care Pub Date : 2018-12-01
Ed Silverman
{"title":"CVS and the $100,000 QALY.","authors":"Ed Silverman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The PBM unit of the health giant CVS decided that any new drug exceeding $100,000 per quality-adjusted life year (QALY) may be excluded from the formularies that are maintained by its clients. Patient groups (with the backing of pharma) say that the measure is discriminatory.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 12","pages":"14-15"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36845171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Why drug prices will continue to roil the waters-and why Scott Gottlieb, MD, will be in the center of the action. 为什么药品价格将继续搅动水-为什么医学博士斯科特戈特利布将处于行动的中心。
Managed Care Pub Date : 2018-12-01
Jan Greene
{"title":"Why drug prices will continue to roil the waters-and why Scott Gottlieb, MD, will be in the center of the action.","authors":"Jan Greene","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We'll see what happens to the administration's Part B proposal. Congress is not likely to take bold action, partly because drugmakers are a strong influence on both parties. That leaves the FDA and Administrator Scott Gottlieb, MD, as major players in efforts to rein in drug prices.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 12","pages":"23-28"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36844120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
And with MIPS, we just don't know yet. 对于MIPS，我们还不知道。
Managed Care Pub Date : 2018-11-01
Michael D Dalzell
{"title":"And with MIPS, we just don't know yet.","authors":"Michael D Dalzell","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>It may take a little while longer to ferret out whether MIPS is having CMS's self-described effect-to \"drive improvement in care processes and health outcomes, increase the use of health care information, and reduce the cost of care.\" Already concluding that cost reduction is unlikely, Medpac recommended scraping MIPS altogether.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 11","pages":"35"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36845165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Insurers on a Shopping Spree For All Sorts of Providers. 保险公司疯狂收购各种保险公司。
Managed Care Pub Date : 2018-11-01
Susan Ladika
{"title":"Insurers on a Shopping Spree For All Sorts of Providers.","authors":"Susan Ladika","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>UnitedHealth Group, Humana, Centene, and Anthem have announced billions of dollars of deals to acquire primary care practices, hospice providers, and home health care companies. The insurers' foray into provider territory comes as the traditional contours of American health care are in flux.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 11","pages":"36-38"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36844110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
VBID improves adherence and outcomes. VBID可改善依从性和预后。
Managed Care Pub Date : 2018-11-01
Timothy Kelley
{"title":"VBID improves adherence and outcomes.","authors":"Timothy Kelley","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>But proactive interventions cost money. And value-based insurance design is a tactic that runs against the grain of what insurance companies commonly do: Rather than spread the big costs of the few across the many, it aspires to big savings from a few in exchange for small expenditures on the many.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 11","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36845157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Financial incentives encourage pregnant women to quit smoking. 经济奖励鼓励孕妇戒烟。
Managed Care Pub Date : 2018-11-01
Sarah Kwon
{"title":"Financial incentives encourage pregnant women to quit smoking.","authors":"Sarah Kwon","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To take just one example: A 2017 meta-analysis published in the Cochrane Database of Systematic Reviews found that interventions with financial incentives-typically small vouchers ($50 monthly or less) for retail items like groceries-increased smoking cessation rates during pregnancy.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 11","pages":"32-34"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36845163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An APM That Would Actually Work. 一个真正有用的APM。
Managed Care Pub Date : 2018-11-01
François de Brantes
{"title":"An APM That Would Actually Work.","authors":"François de Brantes","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Think of this alternative payment model as a large set of event-driven care packages that get triggered by consumer-patients. Each care package can be priced and adjusted for the individual's medical history. Providers who want to bid for the care package can, and what they're offering will be available and comparable to other providers.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 11","pages":"42"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36845167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Back from the Dead. ACA Exchange Market Looking Healthy, Hale, and Competitive. 起死回生。ACA交易市场看起来健康、健康、有竞争力。
Managed Care Pub Date : 2018-11-01
Richard Mark Kirkner
{"title":"Back from the Dead. ACA Exchange Market Looking Healthy, Hale, and Competitive.","authors":"Richard Mark Kirkner","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The brighter outlook for 2019 is what happens when the learning curve starts to flatten out. Remember, this market has only existed for five years. Margins over the past six months have exceeded even pre-ACA levels, and loss ratios reached new lows in the second quarter of 2018.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 11","pages":"10-11"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36845154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient-Reported Outcomes: You'll Get a Lot More Response if You Make It Fun To Do. 患者报告的结果:如果你让它变得有趣，你会得到更多的回应。
Managed Care Pub Date : 2018-11-01
Neil Minkoff
{"title":"Patient-Reported Outcomes: You'll Get a Lot More Response if You Make It Fun To Do.","authors":"Neil Minkoff","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>It may seem obvious, but people are more likely to remain engaged in an activity if they find it enjoyable-and outcomes back this up. Among the more than 1,000 patients who enrolled in our multiple sclerosis registry, 95% remained active after one year.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 11","pages":"44-45"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36845170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Accountable Care Organizations Get Different Look in Olde England. 问责制医疗机构在旧英格兰得到不同的看待。
Managed Care Pub Date : 2018-11-01
Robert Royce
{"title":"Accountable Care Organizations Get Different Look in Olde England.","authors":"Robert Royce","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Britain's National Health Service is taking a good look at how Americans do ACOs. But the move toward accountable care in England has already gotten mired in disputes (and confusion) about what organizational form it should take and whether current proposals are legal.</p>","PeriodicalId":39329,"journal":{"name":"Managed Care","volume":"27 11","pages":"46-47"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36844109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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