Medicaid has to evolve into a delivery model that takes into account the uniqueness of each individual-both their specific health status, and issues outside of the traditional healthcare system, such as transportation, living conditions and substance abuse problems, according to insight from Newt Gingrich, founder of the Center for Health Transformation (CHT) and Rishabh Mehrotra, president and CEO of SHPS, a provider of health advocacy and health benefits solutions.
Every morning, Mark Wagar, president of Empire Blue Cross Blue Shield, walks more than a mile through Manhattan to his office on 42nd Street. It's a city of great diversity and that fact that isn't lost on him, especially considering that one in four New Yorkers is an Empire member.
Hartford, conn.-In what industry watchers are calling the biggest example of marketing insurance products through an affinity group, Aetna and UnitedHealth Group will administer and deliver health insurance to AARP members.
National reports-In Idaho, the rate of uninsured is nearly 18%. National research shows that as the cost of health insurance premiums increases, so does the number of small businesses who drop coverage for their employees. And, in general, small businesses are least likely to offer health insurance to their employees.
Washington, D.C.-After months of speculation, the Bush administration named a veteran Health and Human Services (HHS) official to lead the Centers for Medicare and Medicaid Services (CMS) for the next two years.
Some industry behemoths such as the UnitedHealth Group and the Blue Cross Blue Shield Assn. (BCBSA) have decided to keep the member financial services in-house, creating their own banks. Other payers are developing relationships with multiple banks to offset the giants' economies of scale with flexibility and portability, allowing members to keep their money in the same bank even when they change health plans.
Last month, the LA Times reported that Blue Cross of California had agreed to change its position on policy cancellations, now making a distinction between those who make honest mistakes on application forms and those who fraudulently misrepresent themselves to obtain benefits. The Times predicted that the class-action settlement would "send shock waves" through the insurance industry.
An assignment of benefits is a transfer of an insured's interest in policy benefits to another party. The policy generally requires a written assignment by the insured to the provider, allowing the provider to bill the health plan directly. Such an assignment results in the payment of medical benefits directly to the healthcare provider rather than to the insured.
Economists and health experts on all sides are clamoring for more evidence on how medical products and procedures compare in safety, efficacy and cost. Legislative proposals before Congress include a range of initiatives to spur more comparative effectiveness (CE) research.
Trumpeting the now-popular battle cry of transparency, many states are attempting to control the contractual arrangements between pharmacy benefit services providers and their clients. Because of the historical issues around hidden revenue streams and misaligned objectives, it is no wonder the public sector is taking note.
State regulation of pharmacy benefit managers (PBMs) would benefit states and consumers by providing a regulatory framework for the only entity involved in delivery of a healthcare benefit to the consumer that is largely unregulated.
Briefs of FDA actions/approvals of drugs, doses, and indications
A summary of several automated IV and syringe preparation systems and a discussion of the technology's impact on pharmacy efficiency.
A phase 3 study evaluating the use of gabapentin alone and in combination with an antidepressant in women with hot flashes who had an inadequate response with antidepressant monotherapy demonstrated that gabapentin reduced hot flashes by approximately 50%, whereas the combination of an anti-depressant with gabapentin appeared to offer no additional benefit.
A review of agents in late-stage development for the treatment of HIV/AIDS (May 2007).
Briefs of FDA actions/approvals of drugs, doses, and indications
Pediatric exclusivity program and generic biotech therapies as related to PDUFA IV.
Results of a study conducted to determine whether users of nonformulary blood glucose meters would increase their formulary compliance if they were provided with targeted information and an offer for a free formulary meter.
A summary of several automated IV and syringe preparation systems and a discussion of the technology's impact on pharmacy efficiency.
Patients with silent ischemia but no coronary artery disease (CAD) may benefit from treatment with antianginal drug therapy, according to results of The Swiss Interventional Study on Silent Ischemia Type I (SWISS II)
Nicotine patches used for smoking cessation are safe in patients with coronary artery disease (CAD) and active stress-induced myocardial ischemia, according to the results of a randomized trial.
An 80-mg dose of atorvastatin administered 12 hours before angioplasty, followed by a 40-mg dose administered 2 hours before the procedure significantly reduces the risk of major cardiovascular events during the month after the intervention, according to the results of The Atorvastatin for Reduction of Myocardial Damage during Angioplasty-Acute Coronary Syndromes (ARMYDA-ACS) trial.
Results of FUSION II, a randomized, double-blind, placebo-controlled study involving 920 patients with stage D chronic decompensated HF, presented at the 56th Annual Scientific Session of the ACC.
New research presented at the AAD's 65th Annual Meeting regarding treatment of biologic psoriasis with adalimumab and efalizumab.
A meta-analysis of randomized controlled trials demonstrated that anticoagulant prophylaxis of hospitalized patients statistically significantly reduced their risk of developing both a pulmonary embolism (PE) and deep vein thrombosis (DVT).
Intensive statin therapy in elderly patients may be more effective than moderate statin therapy in improving lipid levels and reducing all-cause death, according to a prospective, international, multicenter, randomized, double-blind, double-dummy, parallel-arm trial in elderly patients with documented coronary artery disease (CAD).
Patients with osteoarthritis or rheumatoid arthritis who are taking etoricoxib may experience significantly fewer upper gastrointestinal (GI) events compared with those taking diclofenac, according to the pooled results of 3 randomized trials.
Sorafenib significantly improves progression-free survival in patients with advanced clear-cell renal-cell carcinoma, according to results from a phase 3, randomized, double-blind, placebo-controlled trial.
In a systematic review and meta-analysis, the use of beta-carotene, vitamin A, and vitamin E, either alone or combined, was associated with an increased risk of all-cause mortality.
