Blog 2017-04-02T13:27:54+00:00

Value-Based Contract Barriers for Innovative Medicines

By | September 5th, 2017|Categories: Big Data, Managed Care, Trends|Tags: , , , |

The shift under way in payment in US health care - from volume to value - has sparked interest in new contracting arrangements to pay for prescription drugs. The objective of these new arrangements is to reward successful outcomes of medication use in patients, rather than pay based on the volume of drugs sold. Unfortunately, value-based contract barriers stand in the way of one approach to managing drug costs and obtaining better value for money spent. However, achieving the full potential of these contracts will necessitate regulatory and other changes.

Insurance Markets Stabilization: Bipartisan Proposal From Governors

By | September 5th, 2017|Categories: Health Care Reform, Managed Care, Medicare and Medicaid, Taxes|Tags: , , , |

The governors John Kasich of Ohio, John Hickenlooper of Colorado, Brian Sandoval of Nevada, Tom Wolf of Pennsylvania, Bill Walker of Alaska, Terence R. McAuliffe of Virginia, John Bel Edwards of Louisiana, and Steve Bullock of Montana sent a letter to the Republican and Democratic leaders of the House and Senate asking them to take immediate steps to restore insurance markets stabilization structures. The letter was sent ahead of the testimony governors are expected to offer to the Senate Health, Education, Labor, and Pensions committee on September 7.

Drug-Related Risks and Outcomes: 1st Annual National Report

By | September 5th, 2017|Categories: Big Data, Managed Care, Population Health, Trends, Uncategorized|Tags: , , , |

The purpose of this first annual surveillance report is to summarize the latest information available on the national level for various drug-related risks and health outcomes, health behaviors, and prescribing patterns related to the drug problem in the United States. The most recent year of information available is different for different outcomes. The emphasis is on national information, but some state information is also presented. This document is intended to serve as a resource for payers, providers, and pharma companies charged with addressing this ongoing national problem. It will be updated annually.

Health Insurance Tax (HIT) Impact on Medicare Plans: 2 Views

By | August 30th, 2017|Categories: Medicare and Medicaid, News and Events|Tags: , , , , |

Sweeping repeal and replace legislation may be slowed, but does not mean significant healthcare changes are not coming off the legislative wish list. The debate on funding aspects of the healthcare law will likely continue through the 2018 election. The Health Insurance Tax (HIT) comes up for discussion and two organizations presented their takes on HIT's impact on Medicare programs and payers. 

Collaborative Payer Provider Model Enhances Primary Care

By | August 29th, 2017|Categories: Trends|Tags: , , , |

Rising health care costs are threatening the fiscal solvency of patients, employers, payers, and governments. The Collaborative Payer Provider Model (CPPM) addresses this challenge by reinventing the role of the payer into a full-service collaborative ally of the physician. The article written by Thomas Doerr, Lisa Olsen, and Deborah Zimmerman for MDPI AG (Basel, Switzerland) identified and tested elements of the Collaborative Payer Provider Model (CPPM). Also in this post, the summary of the major differences between traditional payers and the CPPM.

Telehealth Payer Laws: Impact and Issues

By | August 29th, 2017|Categories: Telehealth and Telemedicine, Uncategorized|Tags: , , , , |

Payers interested in the market potential of under-served rural populations long for consistent options for offering affordable policies without provider network limitations. The language policymakers use in telehealth legislation may deter provider networks from offering remote services and tying the hands of payers looking to broad service options, according to a the Center for Connected Health Policy (CCHP). The CCHP, with funding from the Milbank Memorial Fund, release a report covering the current state of telehealth payer laws.

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