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
Ceftobiprole is the first anti-MRSA cephalosporin antibiotic to be sumbitted to FDA for approval. If approved, the drug will likely be considered a second-line antibiotic for the treatment of cSSSIs.
This article provides information about pharmacologic and nonpharmacologic treatments that are used to help people stop smoking, including the use of varenicline.
FDA-related information through February 2008 on Fluvoxamine extended-release capsules, dalbavancin, bazedoxifene, HPV vaccine (Cervarix), valrubicin, motexafin gadolinium, COL-003, CDX-110, sugammadex, mecaserim rinfabate, A-001, beclomethasone, clobazam, fludarabine tablets, JZP-8, and AST-120
FDA-related information through February 2008 on Fluvoxamine extended-release capsules, dalbavancin, bazedoxifene, HPV vaccine (Cervarix), valrubicin, motexafin gadolinium, COL-003, CDX-110, sugammadex, mecaserim rinfabate, A-001, beclomethasone, clobazam, fludarabine tablets, JZP-8, and AST-120
Studies show that patients with behavioral health conditions are less apt to be compliant with medications than other patients, but many of their reasons for non-compliance are equally applicable to all drugs.
Studies show that patients with behavioral health conditions are less apt to be compliant with medications than other patients, but many of their reasons for non-compliance are equally applicable to all drugs.
Although prevention has become a key element in traditional disease management programs-trying to prevent or mitigate a chronic disease before it exacerbates-that may not be sufficient when a patient has a late-stage or end-of-life condition. There is a new emphasis on caring for older adults with multiple comorbidities. Almost 80% of people 65 and older report having a chronic illness, according to the Robert Wood Johnson Foundation.
Washington, D.C.-National healthcare spending rose 6.7% in 2006 to $2.1 trillion, just slightly faster than the previous year but still fairly stable. Overall, outlays for healthcare reflected a continued slowdown from the double-digit growth rates of the 1990s. Payments for most major health services-hospitals, physicians, nursing homes, home health services-experienced slower growth than 2005.
HIPAA prohibits group plans from charging higher premiums to individuals due to health status, medical history, genetic information, claims experience, receipt of care or evidence of disability. The Department of Labor's Employee Benefits Security Administration recently issued guidelines that closed off a loophole that might have allowed employers to charge less healthy workers higher deductibles.
One of the most important therapeutic classes according is going to be cancer and transplant. "In fact, its contribution to spending increases over the next three years is definitely underestimated here since our projections are based on pharmacy claims data and a large portion of the spending for cancer treatments is paid through the medical benefit," says Lon Castle, MD, senior director, department of medical and analytical affairs at Medco.
Realizing economic benefits of eHealth information sharing, forward thinking payers began working years ago to sponsor multi-payer web communications platforms that allow providers to communicate with many sponsors from one access point.