A recent CNN story ended with the California Insurance Commissioner, Dave Jones, opening an investigation into Aetna. CNN interviewed a former medical director for Aetna, Dr. Jay Ken Iinuma, where he admitted to never looking at patients' records when deciding to approve or deny care! Find out more […]
Highest Healthcare Spenders – Hard to Predict
A recent New England Journal of Medicine report found it difficult to predict which individuals would be the biggest spenders, and found that the top 5% of healthcare spenders in 2015 accounted for 53% of healthcare spending. Find out more here. (Les Masterson, HealthcareDIVE, 2/5/18) […]
Express Scripts Says Per-Person Spending is Decreasing
Express Scripts Holding Co. Inc. recently released their 2017 Drug Trend Report. The report showed a decrease in the increase of per-person prescription drug spending; per-person prescription drug spending rose by only 1.5%, compared to 3.8% in 2016. Find out more here. (Source: Erin Mccallister, […]
Six Healthcare Trends to Watch in 2018
2018 finds the U.S. health care industry on the edge of significant change. Despite shifting market trends and business realities, this article feels confident in making some predictions on what we may see in healthcare for 2018. Read more here. (Source: Health Affairs Blog, 1/29/18) […]
NPC Launches Initiative to Explore Health Care Spending
The National Pharmaceutical Council recently launched a new research-first initiative, Going Below the Surface. The initiative intends to seek constructive answers on how we can spend our health dollars more effectively. Will they be able to move past all the finger pointing? Find out more here. […]
Amazon Makes Its Move on Healthcare
Amazon has made its long anticipated move into health care, joining Berkshire Hathaway and JPMorgan Chase, to form an independent healthcare company. This new company is taking aim at reducing US costs, improving outcomes and will be free from profit making incentives. Read more here. (Source: Gemma […]
Three Corporate Giants Form Independent Healthcare Company
Three companies have recently formed a dream team of sorts, with the aim of improving employee satisfaction and reducing costs for their U.S. employees healthcare. Amazon, Berkshire Hathaway, and JPMorgan Chase & Co recently announced their partnership and say their initial focus will be on […]
Iowa’s Failing Market Design and Their $1M/month Patient
It looks like Iowa has one lone insurer, Medica still standing on the Exchange market. Although many states are having their own health care problems, Iowa is unique in that it has one single individual who easily generates a $1,000,000 a month claim. Could high cost risk pool, invisible reinsurance […]
No Heart Attack or Your Money Back!
The familiar warranties and money-back guarantees are now being used to sell pricey new-generation drugs. These deals negotiated between drugmakers and the insurers won't mean money back for the patient in the case of low-than-expected outcomes, but it will help to reduce wasteful spending and […]
How Will the U.S. Health Act Repeal Affect Unemployment?
The health care industry has been adding jobs at more than 3 times the rate of the rest of the economy since 2007 and has played a big part in decreasing unemployment in the U.S., which is one of the reasons why so many Americans are concerned about this industry will be affected by the Health Act […]
Desperate Diabetics Seek Black Market Insulin
Imagine not being able to afford the life saving medicine for your child needs. Imagine finding a way in which you could get the medicine, but not without potential risks. How high are the risks? Does it matter? Find out more about Families, so desperate, they're looking to the Black Market to get […]
High-Risk Pools for Preexisting Conditions – How Quick We Forget!
Republicans are set on repealing the Affordable Care Act, but when it comes down to replacing the ACA, well, they kind of start to lose focus! Some members of the new administration and Congress are trying to push the idea of creating high-risk pools as a way to cover those with preexisting […]
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Big things happening in the HEOR world! Make sure you keep up-to-date the easy way, with HealthEconomics.Com. HE.Com has a weekly newsletter filled with the latest, most important happenings in the field, as well as the most current conferences, webinars and events. Check out this week's newsletter […]
Lower Drug Prices Don’t Improve Access in Rheumatoid Arthritis
'Perverse incentives' guide US pricing for rheumatoid arthritis drugs, stakeholders say at policy roundtable convened by Institute for Clinical and Economic Review. Subscription required to read more. (Source: Cathy Kelly, Pink Sheet, 4/7/17) […]
Value-Based Health Care Gains Favor Among Employers
A growing number of employers are finding that taking matters into their own hands works best when it comes to improving employee health while managing costs. Part of an ongoing evolution moving away from a focus on volume and toward a focus on value, many employers are bucking the insurance […]
Time for the Doctor’s Revolt – DREXIT
It seems as though people from all over the world are reaching their breaking point with over reaching government and nonsensical regulations. A point where they are no longer just sitting there complaining about it, but they're getting up and DOING something about it, saying, 'We're not gonna take […]
Could We be Drowning in Hospital Waste?
Health care in America is expensive - everyone can agree on that, but, if you're looking for an exact reason... that may be a little harder to find! Every area in healthcare has an explanation for their share and has another group to point fingers at and blame. However, this recent ProPublica […]
Do We Need to Redesign Care for High-Cost, High-Risk Patients?
The burden of high-cost, high-risk patient care is an expense that could be sustainably reduce by simply redesigning the care of such patients. Dealing with a chronic disease or injury is financially, physically and emotionally draining for a patient. Hospital admissions, which may be frequent, come […]
Asthma Biomarker Predicts High Risk – Helps Manage Costs
eMAX Health Systems, LLC recently released the results of new research looking at the health care costs of asthma patients. Patients with elevated peripheral blood eosinophil counts, a key biomarker for severe asthma, show almost 200% higher health care cost than those without ($28,000/yr vs […]
High Deductible Health Plans Causing Diabetes Care Delays
“People with diabetes enrolled in high-deductible healthcare plans — especially the poorer and sicker — are delaying physician visits for preventable complications, which leads to a greater number of expensive emergency department visits, finds a newly published study...High-deductible health plans […]
Does Increased Negotiation Power = Consumer Benefits or Corporate Profits?
A recent study by Harvard Medical School researchers shows large insurers have more power when it comes to negotiations, compared to smaller insurance groups. As far as health insurance megamergers like Aetna-Humana and Anthem-Cigna go, their ability to negotiate would be heightened for sure, but […]
Where are US Health Care Dollars Going?
US health care spending now accounts for more than 17% of the economy, however, not much is known about how spending on each condition varies by age and across time. The objective of this report was to estimate US spending on personal health care and public health, according to condition, age and […]
Can Traditional CER Address Resource Allocation?
While the growth in U.S. healthcare costs is receiving substantial attention, many believe that instead of looking at general contributors, i.e. pharmaceutical pricing, we should look to resource allocation. Could Comparative Effectiveness Research (CER) methods help to answer this or is something […]
How Can the ACA be Repealed Responsibly?
Repealing the ACA is listed to be on top of the incoming administration's list of things to get done, however, with the current proposed repeal, coverage alternatives could be delayed for years. It is essential that any efforts to repeal and replace the current system deliver short-term stability as […]
Repealing ACA Could Cost Hospitals Billions!
At the very least, the U.S. Affordable Care Act is looking at major changes, but there is big push to have it repealed completely. The American Hospital Fssociation and the federation of American Hospitals recently teamed up to look into the financial implications of a total repeal. Their report […]
American Healthcare Spending Reaches $10K per Person
Health Affairs recently published a new analysis from the Office of the Actuary at the Centers for Medicare & Medicaid Services showing a tremendous increase in the 2015 U.S. healthcare spending. Growing at a rate of 5.8%, U.S. healthcare reached $3.2 trillion last year, putting the per person […]
The Interquality Project: How to Control Costs and Improve Access
ISPOR's third plenary session, How to Control Costs and Improve Access to Medicines: Lessons from the InterQuality Project, was moderated by Tomasz Hermanowski. This InterQuality Project investigated the effects of different financing systems on the quality of health care in Poland. Find out more […]
The Cost of Adult Vaccine-Preventable Diseases in U.S.
Health Affairs recently released the results of a new study, funded by Merck, calculating the annual economic burden of diseases associated with vaccines. Learn more here. (Source: HealthAffairs, 10/2016) […]
How Many Americans Deal with Rising Healthcare Costs?
The ever rising cost of healthcare is hot on everyone's mind, but for how many Americans is it really a big deal? Industry analysts say, most americans are ahead of the game. Find out more here. (Source: Beth Pinsker, Managed Health Care Connect, 10/11/16) […]
A Look into the Future of the ACA
The Affordable Care Act is plagued with multiple problems that will not simply disappear on their own. What steps need to be taken to make this work for everyone? Read more here. (Source: Joseph Antos and James Capretta, HealthAffairsBlog, 10/11/16) […]
