Employers are finding themselves between a rock and hard place when it comes to health benefits. If they reduce or eliminate benefits, they lose quality workers as well as productivity. If they maintain or increase benefits, they're almost certain to spend beyond their budgets year after year. In trying to strike a happy medium, more employers are now remodeling their health benefit plans dramatically, hoping to see better results.
When the former owner of the NFL's Cleveland Browns announced he was moving the team to Baltimore in 1996, not only were Cleveland fans outraged, ironically, so were Pittsburgh Steelers fans-their biggest rivals. For the two seasons that the Browns franchise remained dark, the Steelers missed the Browns because they had enjoyed the competitive rivalry. The Browns team and its followers were the people they loved to hate.
Professionals with problematic and tarnished credentials pose serious risk to healthcare consumers and create financial exposure – in the form of CMS fines -- for the institutions that unknowingly employ them. This black cloud now extends to health plans.
Commonwealth Fund Overall Rank (2007): 39
Adding bevacizumab to treatment with paclitaxel does not prolong overall survival among patients with metastatic breast cancer; however, the combination therapy is associated with a significant improvement in progression-free survival, according to the results of a trial published in the New England Journal of Medicine (NEJM).
The campaign against drug TV advertising and marketing seems to be accelerating in Washington and around the country. The latest salvo comes from leaders of the House Energy & Commerce Committee who want information from pharmaceutical companies and the Food and Drug Administration about questionable marketing campaigns.
The Centers for Medicare and Medicaid Services (CMS) has announced it will end Phase I of Medicare Health Support (MHS) program upon completion of the three-year pilot, meant to provide beneficiaries additional care-management services. Expansion to Phase II of any pilot is contingent upon improving the clinical quality of care, improving beneficiary satisfaction and achieving targets for savings.
This article discusses pharmacologic options for the treatment of Crohn's disease, including aminosalicylates, corticosteroids, immunosuppresant agents, and biologic agents.
FDA-related information through March 2008 on C1 inhibitor, ferric carboxymaltose injection, lovastatin, carbidopa/levodopa extended release, vigabatrin, bortezomib, peginterferon alfa-2b, elesclomol, triphendiol, VQD-002
Etravirine is a second-generation non-nucleoside reverse transcriptase inhibitor (NNRTI) that was approved January 18, 2008, for use in combination with other antiretroviral agents for the treatment of HIV-1 infection in antiretroviral treatment-experienced adult patients who have evidence of viral replication and HIV-1 strains resistant to NNRTIs and other antiretroviral agents.
A review of agents in late-stage development as of March 2008 for the treatment of diabetic retinopathy, dry eye syndrome, macular degeneration, and diabetic macular edema
Health and productivity management (HPM), disease management (DM), and wellness programs continue to gain traction in the corporate marketplace. As employers and vendors address gaps, these programs will become fundamental in employer efforts to contain health benefit costs, better manage benefit use, and achieve transparency across employee data.
Despite efforts of healthcare payers and providers, the vast majority of daily healthcare discussions have taken place outside of the industry. People talk to family and friends in varied settings - at home, parties, restaurants, health clubs, and religious and community institutions where the industry has no voice.
Healthcare forecasters might assume that because of demographics, heart disease would be a leading cause of increased demand for hospital services-and, therefore, healthcare costs.
MEDICATION THERAPY Management (MTM) services introduced in 2006 under Medicare Part D have prompted pharmacists to adopt expanded roles in the commercial setting, such as performing a comprehensive medication review and monitoring a patient's response to therapy. One of the main caveats, however, is the lack of standardized reimbursement for pharmacists' services.
An increasing number of studies are linking oral health to general health. While not establishing a direct cause-and-effect, the reports show that early prevention and treatment of gum disease could improve outcomes for pregnancy, heart disease and diabetes.
According to the 2007 Milken Institute Report, "An Unhealthy America: The Economic Burden of Chronic Disease," prevention, early detection and chronic condition management could save the nation $1 trillion annually by 2023. But in the mind of U.S. Preventive Medicine Founder (USPM), Chairman, CEO and Director Christopher Fey, there is something even more important that could be saved: lives.
George Clooney's challenges make for good TV. While the former star of "ER" struggles with fictional patients, much of the drama in today's emergency department (ED) centers around the problems of overcrowding, increased utilization and increased wait times.
If you had $40 million to spend each year on a philanthropic mission in healthcare, what would your mission be? Helping the uninsured? Bankrolling demonstration projects? To deliver the greatest impact within the $2 trillion U.S. healthcare system, you would have to be choosy about your commitments.
Across the country, state and local lawmakers are discussing various mechanisms to provide healthcare coverage to uninsured residents, and some states have recently enacted such legislation. Some of these laws include the requirement to make employers fund at least part of the states' health insurance programs.
In response to continued complaints from Medicare beneficiaries about unscrupulous sales reps and misleading plan information, members of Congress and state insurance regulators are urging better oversight of Medicare Advantage and Part D plans. The Centers for Medicare and Medicaid Services (CMS) says it is beefing up policies and enforcing rules with more vigor.
Commonwealth Fund State Performance Ranking (2007): 26
National Reports-Wal-Mart's recent announcement that it plans to enter the pharmacy benefits arena has perked up a few ears in the industry.
Washington, D.C.-The campaign to combat rising healthcare costs is now targeting industry methods for calculating "reasonable and customary" rates for coverage of out-of-network medical expenses. New York Attorney General Andrew Cuomo filed lawsuits last month against UnitedHealth Group and several subsidiaries for allegedly using "rigged data" and fraudulent methods to manipulate reimbursement rates.
The link between gum disease and systemic disease is becoming more top-of-mind with health plan and dental providers alike.
The use of rosiglitazone to treat type 2 diabetes in older patients has been associated with an increased risk of cardiovascular events.
In 2 studies, lenalidomide plus dexamethasone has been demonstrated to be an effective therapy for relapsed and/or refractory multiple myeloma.
Report by FDA's Science Board cites a need for updates to the agency's information infrastructure and research programs to avoid significant problems.
First-time generic approval: Granisetron injection
A summary of drugs and indications recently approved by FDA: Cialis, Evicel, Voluven, Thyrogen, Diovan, Cymbalta, Triesence, Vyvanse, Glumetza, Sular