In the healthcare industry, most executives have placed huge caveats on their organization's plans for 2015. Looming this year are three potential game changers: the United States Supreme Court's King v. Burwell decision, a new Republican-controlled Senate's actions on the Affordable Care Act (ACA) and the implementation of ICD-10.
While ICD-10 implementation has been delayed until October 2015, providers must appreciate that many current managed care agreements likely include binding language that will impact reimbursement changes, particularly for inpatient services.
Healthcare leaders expect to recoup investments in technology, staff and facilities that support new models of care such as accountable care organizations within four years, according to a new survey.
Health insurance websites, including exchange sites, health plan sites and aggregator sites, are on an upward trend since the rocky debut in 2014 of HealthCare.gov.
Unlike a traditional formulary, the value-based formulary emphasizes the clinical effectiveness of a drug rather than cost so that if a drug is very effective but expensive, it might still fall on tier one.
From Blue Shield of California's recently-announced purchase of a Medicaid plan to Partners HealthCare's hard-fought effort to fold more hospitals into its Massachusetts health system, the volume of mergers and acquisitions in the healthcare sector has steadily climbed and now exceeds M & A activities in all other U.S. industries. The surge is being fueled by payers and providers seeking new business opportunities in the post-ACA healthcare market, and 2015 is on track to be another record-breaking year.
Because the imaging industry has been under a microscope for years, it's had to do more with less. There are many ways in which imaging can serve as a blueprint for other stakeholders as healthcare moves toward value-based care delivery models.
Envisioning a public health threat, managed care recently notched up its readiness for an Ebola outbreak in the United States. Valuable lessons emerged from the latest effort, adding to the knowledge gleaned from other epidemics, such as the HIV/AIDS and SARS viruses and the bird flu.
Nearly a year after two medical societies released a national consensus statement on the safe prevention of certain C-sections, broad consensus seems to boil down to this: Steps must be taken to lower C-section rates in the U.S., and strong outreach to ob/gyns is critical for success.
CMS Administrator Marilyn Tavenner, a life-long public health advocate tapped to lead the $820 billion federal agency, will step down from her role at the end of February.
While one study finds up to 80% of mid-sized employers are increasing the employee share of health insurance deductibles and co-pays, another finds the amount of employee contributions has declined in the past few years.
The world’s leading 30 pharmaceutical companies spent a combined $112 billion on research and development (R&D) in 2013, an increase of $723 million over the previous year. According to our new Global Pharmaceutical Benchmark Report, Roche was the R&D spending leader, outlaying nearly $10 billion in 2013. Meanwhile, Novartis and Johnson & Johnson (J&J) increased their R&D spend the most between 2012 and 2013, with each adding around $500 million to their respective clinics. Novartis’ R&D spending grew by 5.6% to $9.8 billion, and J&J spent $8.2 billion, which was up by 6.8% from 2012.
Patient-centered care tailored to individuals is needed to treat and monitor the 100 million Americans who live with chronic pain, an independent panel convened by the National Institutes of Health (NIH) has concluded.
Limiting drug insurance is not an effective strategy for reducing the rising healthcare costs in the U.S., according to an analysis published online this month in the American Journal of Public Health.
FDA approved the Maestro Rechargeable System, the first weight loss treatment device that targets the nerve pathway between the brain and the stomach that controls feelings of hunger and fullness.
The Centers for Disease Control’s new guidance that hospitalized and high-risk patients with unconfirmed but suspected flu should be administered anti-virals without waiting may cause additional medication shortages, according to a pharmacist and professor.
FDA has approved long-acting release (LAR) pasireotide (Signifor, Novartis) for injectable suspension, for intramuscular use, for the treatment of patients with acromegaly who have had an inadequate response to surgery and/or for whom surgery is not an option.
Health insurer Aetna will increase the minimum hourly wage to $16 an hour and enhance medical benefits to lower out-of-pocket costs for employees, the company announced Monday.
It’s no secret that the compounding industry is under greater scrutiny these days. A number of high-profile cases, including recent deaths linked to outsourced intravenous (IV) compounding at a Texas hospital, have moved patient safety concerns front and center.1 In the wake of ongoing fallout and a 2-year crackdown on compounding centers by FDA, many hospitals are analyzing their current strategy and rethinking the pros and cons of outsourced IV compounding.
FDA has approved gadobutrol (Gadavist, Bayer HealthCare) injection for use with magnetic resonance imaging (MRI) in pediatric patients aged younger than 2 years to detect and visualize areas with disrupted blood brain barrier and/or abnormal vascularity of the central nervous system. It is the first gadolinium-based contrast agent for patients aged younger than 2 years, including term neonates
Afatinib extends overall survival in lung cancer patients whose tumors have the most common epidermal growth factor receptor (EGFR) mutation compared with chemotherapy, according to study results published in The Lancet Oncology from 2 independent phase 3 clinical trials in EGFR mutation-positive patients with metastatic non-small cell lung cancer (NSCLC).
FDA has approved carbidopa-levodopa (Duopa, AbbVie) enteral suspension for the treatment of patients with advanced Parkinson’s disease.
Prostate cancer is the most frequently diagnosed cancer, aside from non-melanoma skin cancer, in men in the United States. According to the American Cancer Society, an estimated 233,000 new cases of prostate cancer and an estimated 29,480 deaths from prostate cancer will have occurred in the United States during 2014. About 60% of all prostate cancer cases are diagnosed in men aged 65 years and older, and 97% of cases occur in men aged 50 and older. The incidence of prostate cancer is 60% higher in African Americans than in whites.
CMS' guidelines are helping Medicare Advantage organizations to develop and implement member rewards programs that improve health and prevent injury and illness.
In a drug safety communication, FDA said that it is aware of recent reports questioning the safety of prescription and over-the-counter (OTC) pain drugs when used during pregnancy, but that it lacks adequate studies to change current recommendations.
Arkansas and Iowa, two GOP-led states, have received approval for customized options for Medicaid expansion that include cost-sharing provisions for beneficiaries.
A new Commonwealth Fund study finds that, following implementation of the Affordable Care Act, premiums for employer-sponsored insurance in 31 states grew more slowly than in previous years.
The factor Xa inhibitor edoxaban (Savaysa, Daiichi Sankyo) has been approved by FDA to lower the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (AF).
FDA approved a supplemental biologics license application (sBLA) for obinutuzumab (Gazyva, Genentech, a member of the Roche Group) in combination with chlorambucil chemotherapy in people with previously untreated chronic lymphocytic leukemia (CLL).
FDA approved an extended-release oral capsule formulation of carbidopa-levodopa (Rytary, Impax Pharmaceuticals, a division of Impax Laboratories, Inc.) for the treatment of Parkinson's disease, post-encephalitic parkinsonism, and parkinsonism that may follow carbon monoxide intoxication and / or manganese intoxication.
