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1.
Manag Care ; 28(5): 19, 2019 May.
Article in English | MEDLINE | ID: mdl-31188106

ABSTRACT

A study designed to test whether eliminating copays would improve adherence to antiplatelet therapy showed that, yes, indeed, it does. But the results also showed no reduction in major cardiovascular events among those who stuck with the medication.


Subject(s)
Platelet Aggregation Inhibitors/economics , Insurance , Medication Adherence
2.
Manag Care ; 28(4): 24-25, 2019 Apr.
Article in English | MEDLINE | ID: mdl-31188118

ABSTRACT

It is a high-tech wonder and the product of generations of heavy investment in trauma care. But the emergency department is also the backdoor of the American health care system-a kind of open wound that is symptomatic of deficiencies of how American health care is organized, delivered, and paid for.


Subject(s)
Emergency Medical Services , Emergency Service, Hospital , United States
3.
Manag Care ; 28(1): 12-15, 2019 Jan.
Article in English | MEDLINE | ID: mdl-30883317

ABSTRACT

Lyman has emerged as an important voice about biosimilars and their potential for corralling cancer costs. It's personal because Lyman is all too aware of how the price of medications can ruin patients financially. We need more biosimilars on the market, he contends.


Subject(s)
Antineoplastic Agents/economics , Biosimilar Pharmaceuticals/economics , Neoplasms/drug therapy , Antineoplastic Agents/therapeutic use , Biosimilar Pharmaceuticals/therapeutic use , Costs and Cost Analysis , Humans
4.
Manag Care ; 27(3): 25-29, 2018 03.
Article in English | MEDLINE | ID: mdl-29595465

ABSTRACT

The insurer's vice president of provider alignment solutions says: "We're going to start to signal to providers that if you are going to stay an upside-only arrangement, we're not going to give you free money forever in the form of the care-coordination fees that we've been paying out. They're not an entitlement."


Subject(s)
Insurance Carriers/economics , Organizational Innovation , Humans , Organizational Case Studies , Risk , United States
5.
Manag Care ; 27(1): 23-27, 2018 01.
Article in English | MEDLINE | ID: mdl-29369766

ABSTRACT

Insurers are playing "small ball" and not showing leadership, says the former congressman. And some "spin-dry" inpatient providers are doing more harm than good in combating the opioid epidemic. Meanwhile, Kennedy, who chronicled his own harrowing mental health and addiction struggles in a 2015 memoir, says he has been sober for more than six years.


Subject(s)
Insurance Coverage/legislation & jurisprudence , Insurance, Psychiatric/legislation & jurisprudence , Mental Health Services/economics , Mental Health Services/legislation & jurisprudence , Substance-Related Disorders/therapy , Healthcare Disparities , Humans , Politics , Social Justice , United States
6.
Manag Care ; 27(12): 34-36, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30620326

ABSTRACT

Blue Health Intelligence conducted an analysis of a commercial health plan claims database and adverse events that is designed to paint a fuller, real-world picture of adverse events. The database included patients, ages 18-64, admitted to the hospital in 2016 and 2017.


Subject(s)
Databases, Factual , Drug-Related Side Effects and Adverse Reactions/epidemiology , Hospitalization , Adolescent , Adult , Aged , Humans , Middle Aged , Retrospective Studies , Young Adult
7.
Manag Care ; 26(12): 36-41, 2017 12.
Article in English | MEDLINE | ID: mdl-29272244

ABSTRACT

This professor of pharmaceutical economics in the University of Minnesota College of Pharmacy says that the rising level of health care spending is unsustainable. He argues that drug price increases should be reviewed and PBMs should be regulated. "We need [a] bona fide rate regulation review body that can meaningfully evaluate the information presented by drug companies."


Subject(s)
Cost Control , Drug Costs , Managed Care Programs/economics , Humans , United States
8.
Manag Care ; 26(7): 37, 2017 Jul.
Article in English | MEDLINE | ID: mdl-28895837

ABSTRACT

The Democratic governor and the Republican legislature have moved to shore up the individual market, but Minnesotans are leaving it in droves. About 167,000 residents bought individual coverage this year, compared with 270,000 in 2016. Premium hikes have been caused, in part, by the consolidation of providers.


Subject(s)
Delivery of Health Care , Physicians , Consumer Behavior , Minnesota
9.
Manag Care ; 26(4): 30-33, 2017 04.
Article in English | MEDLINE | ID: mdl-28511762

ABSTRACT

The CMO of Teladoc, one of the country's largest telemedicine providers, certainly knows how to sing the praises of the industry, and handle devil's advocate kind of questions as well. Most of Teledoc's customers are commercial insurers and employers. Medicare? Not so much. Medicaid makes "perfect sense."


Subject(s)
Primary Health Care , Telemedicine , Patient-Centered Care , United States
10.
Manag Care ; 26(2): 32-34, 2017 02.
Article in English | MEDLINE | ID: mdl-28271989

ABSTRACT

Journalist David France's How to Survive A Plague is a searing firsthand account of the early years of the HIV/AIDS epidemic in New York City. AIDS activists, most of them gay men, were fighting for their lives. Researchers, politicians, public health officials, and pharma were slow to respond-or resisted outright.


Subject(s)
HIV Infections , Patient Advocacy , Politics , Humans , United States
17.
Manag Care ; 25(2): 39-40, 2016 Feb.
Article in English | MEDLINE | ID: mdl-27008835
19.
Manag Care ; 25(7): 16-20, 2016 07.
Article in English | MEDLINE | ID: mdl-28121526

ABSTRACT

The development of recombinant DNA and other technologies has added a new dimension to care. These medications have revolutionized the treatment of rheumatoid arthritis and many of the other 80 or so autoimmune diseases. But they can be budget busters and have a tricky side effect profile.


Subject(s)
Arthritis, Rheumatoid/drug therapy , Biological Products/therapeutic use , Antirheumatic Agents , Drug-Related Side Effects and Adverse Reactions , Humans
20.
Manag Care ; 25(9): 37-40, 2016 09.
Article in English | MEDLINE | ID: mdl-28121574

ABSTRACT

Medicaid expansion often means a hollow benefit, says Scott Gottlieb, MD, a resident fellow at the American Enterprise Institute and a leading conservative expert on health care policy. And the exchanges are in trouble with little political support. But Gottlieb says there will be some reluctance for sweeping reform because of a "fatigue factor," so targeting the exchanges may be the best way forward for Republicans.


Subject(s)
Health Care Reform/legislation & jurisprudence , Patient Protection and Affordable Care Act , Politics , Humans , United States
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