Bundled Payments Systems Part of Healthcare Reform
- Tue, 1/4/11 - 10:19am
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Las Vegas—If providers are reimbursed through bundled payments there could be an estimated $17.8 billion in Medicare savings through 2019, mainly from a reduction in readmissions to hospitals, according to Jonathan W. Pearce, MBA, director at DGA Partners, a healthcare management consulting firm. Mr. Pearce spoke at the Fall Managed Care Forum during a session titled Running the Numbers on Bundled Payments.
Accountable Care Organizations’ Role in the Evolving Healthcare Industry
- Tue, 1/4/11 - 9:35am
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Las Vegas—Although accountable care organizations (ACOs) have not been well defined and are still a mystery to many in the healthcare industry, ACOs will likely play a major role in coming years as providers will be held more accountable for controlling costs and improving clinical outcomes. ACOs were discussed during a session at the Fall Managed Care Forum titled Running the Numbers on Accountable Care Organizations.
Biologics Becoming More Popular in Treating Chronic Diseases
- Thu, 11/18/10 - 2:33pm
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St. Louis—At a satellite symposium at the AMCP meeting, a trio of speakers discussed the use of biologics in chronic diseases as well as the different pharmacy benefit designs, opportunities, challenges, trends, and costs associated with the drugs. The symposium was titled Evolving Role in the Treatment of Chronic Diseases: Value-Driven Benefit Design and Utilization Management Strategies.
Pharmacy Fraud and Crime: Challenges to Insurers, PBMs
- Thu, 11/18/10 - 2:31pm
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St. Louis—Health insurers, pharmacy benefit managers (PBMs), and other healthcare and pharmacy-related businesses must take seriously the impact and high costs associated with pharmacy fraud and crime, according to information presented during a Contemporary Issues session at the AMCP meeting titled Pharmacy Fraud and Crime—Impact on Managed Care.
Worldwide Dementia Costs Reach $604 Billion
- Thu, 10/21/10 - 9:39am
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Buoyed by 2 recent studies highlighting the enormous costs associated with dementia, advocates are pushing the White House and Congress to understand the disease’s severity, fund research to find treatments and a potential cure, and form a national strategy to combat dementia.
Healthcare Reform Big Issue in Elections
- Thu, 10/21/10 - 9:00am
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Leading up to the November elections, the political parties spent countless hours and millions of dollars debating the merits of the Patient Protection and Affordable Care Act (HR 3590). Republicans criticized Democrats who voted for or supported healthcare reform, citing surveys showing many Americans opposed the law. Some Democrats defended the legislation and touted it as a landmark accomplishment in helping uninsured Americans, while others chose to ignore the issue or even derided the law because of its polarizing nature among the public.
Medical Costs Associated With Obesity At $147 Billion
- Mon, 9/27/10 - 10:11am
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The increasing number of obese people in the United States has led to serious health conditions, reduced quality of life, and escalating costs, according to a study released by the Centers for Disease Control and Prevention (CDC) in August. The study, “Vital Signs: State-Specific Obesity Prevalence Among Adults—United States, 2009,” revealed that medical costs associated with obesity in 2006 were approximately $147 billion (in 2008 dollars).
Major Health Reform Initiatives Go Into Effect
- Mon, 9/27/10 - 10:10am
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Six months after President Barack Obama signed the Patient Protection and Affordable Care Act (HR 3590), several provisions of the healthcare reform bill were recently enacted. The legislation significantly altered the healthcare industry, and the rules implemented in late September will likely have a major impact on consumers, state and national government, health insurers and other businesses.
Time to Fill the Doughnut Hole
- Wed, 9/22/10 - 1:17pm
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- 385 reads
Rebate checks are being mailed to Medicare beneficiaries who reach the prescription drug coverage gap, known as the doughnut hole, and provisions in the recently passed national healthcare laws are intended to eliminate the coverage gap entirely. The Centers for Medicare & Medicaid Services (CMS) has provided Medicare Part D sponsors with guidance on providing discounted drugs to beneficiaries in the coverage gap starting next year, and the US Department of Health and Human Services says the doughnut hole will be filled by 2020.
High-Risk Pool is Open
- Wed, 9/22/10 - 12:54pm
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- 426 reads
On July 1, the US Department of Health and Human Services (HHS) announced the establishment of a new Pre-existing Condition Insurance Plan (PCIP) that will offer coverage to uninsured Americans who have been unable to obtain health coverage because of a pre-existing health condition. The PCIP, created under the Patient Protection and Affordable Care Act (HR 3590) that was enacted in March, will be administered either by a individual states or by HHS.
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