Prescription Benefits

CMS Final Rule for Drug Prices in Advertising

[vc_row][vc_column][rev_slider_vc alias="cms-final-drug-rule"][/vc_column][/vc_row][vc_row][vc_column width="1/2"][vc_column_text]A rule proposed in October of last year has become final on May 8, 2019. This rule would mandate that pharmaceutical companies publish the prices of any medication with a list price greater than $35 during television ads. Pharmaceutical companies tried to push back on this rule stating that listing the prices would confuse patients since what they pay will be different due to insurance coverage, rebates, and discounts....

Donna White
Share
data healthcare 1

Data in Today’s Healthcare Market

[vc_row][vc_column][rev_slider_vc alias="data-in-healthcare"][/vc_column][/vc_row][vc_row][vc_column width="1/2"][vc_column_text]Since the introduction of the HITECH Act, there has been a fast-paced shift to incorporate technology into healthcare. With a focus on improving patient outcomes and establishing true interoperability as the Act originally intended, we have fallen quite short of that mark. However, better utilization of data from our systems can help with business decisions, patient care, and yes, even interoperability. In a recent review from NTT Data Services,...

Donna White
Share
antibiotic

Telemedicine and Increased Antibiotics Prescriptions for Kids

[vc_row][vc_column][rev_slider_vc alias="increased-antibio"][/vc_column][/vc_row][vc_row][vc_column width="1/2"][vc_column_text]We have been reviewing telemedicine a lot lately. Telemedicine is still in its infancy, with many providers hesitant to jump in. One specialty, however, has been increasing their telehealth visits, and that is pediatrics. And while there have been numerous studies on the benefits of telemedicine for adults, there have been very few regarding the effects on children. A new study has found that children with cold symptoms seen...

Donna White
Share
medical bills

Congress Tackles Surprise Medical Bills

[vc_row][vc_column][rev_slider_vc alias="surprise-bills"][/vc_column][/vc_row][vc_row][vc_column width="1/2"][vc_column_text]In a rare bi-partisan effort this week, the House Health, Employment, Labor and Pensions subcommittee heard testimony regarding what can be done to prevent patients from receiving medical bills for which they are unprepared. How can that happen? In several ways. For example, a patient can be seen in the Emergency room, pay their ER co-pay and expect the rest to be covered according to their insurance plan guidelines....

Donna White
Share
telehealth patient

Telehealth Utilization by Patients on the Rise

[vc_row][vc_column][rev_slider_vc alias="telehealth-patients"][/vc_column][/vc_row][vc_row][vc_column width="1/2"][vc_column_text] Stanford Children’s Health in Palo Alto, CA has grown their telehealth program exponentially over the last three years. Their goal is to be more patient-centered, making healthcare more convenient and accessible. From just 192 visits in 2017 to 1,500 already in the first few months of 2019, this practice has learned the value of providing telehealth in modern medicine. This is typically the exception to the rule. Even in...

Donna White
Share
medical technology

Smart Watches and Your Health

[vc_row][vc_column][rev_slider_vc alias="technology"][/vc_column][/vc_row][vc_row][vc_column width="1/2"][vc_column_text] The University of Michigan has started a study of how smart watches, particularly the Apple Watch, can track and monitor patient's blood pressure and heart rate. The study looks to review how that translates to chronic health symptoms, and if the data they provide can help providers diagnose and treat certain conditions. This study will go for three years and is called the Michigan Predictive Activity and Clinical Trajectories...

Donna White
Share
medical director

Insurance Medical Director Denied Care without Review

[vc_row][vc_column][rev_slider_vc alias="medical-review"][/vc_column][/vc_row][vc_row][vc_column width="1/2"][vc_column_text] Last week it was reported in an exclusive by CNN, that former Aetna Medical Director, Dr. Jay Ken Iinuma, testified during a deposition that “he never looked at patients’ records when deciding whether to approve or deny care.” This deposition was in response to a lawsuit filed against Aetna by Gillen Washington who suffers from a rare disease and was denied coverage for a medically necessary treatment related to...

Donna White
Share
CMS Spending Growth

CMS Projects Exponential Growth of Healthcare Spending

[vc_row][vc_column][rev_slider_vc alias="spending-growth"][/vc_column][/vc_row][vc_row][vc_column width="1/2"][vc_column_text] A new report from CMS recently published in Health Affairs, states that the US is projected to spend $5.96 trillion on healthcare in 2027. This would be a 19.4 percent share of the gross domestic product (GDP). In 2017, healthcare spending accounted for 17.9 percent of the GDP. The largest catalyst behind this projected growth is the aging population. With people living longer and reaching the age of Medicare...

Donna White
Share
Increased Spending

Private Insurers, not Medicare or Medicaid, are behind increased healthcare spending

[vc_row][vc_column][rev_slider_vc alias="increased-spending"][/vc_column][/vc_row][vc_row][vc_column width="1/2"][vc_column_text] A new study released this week by The Urban Institute shows that Medicare and Medicaid spending is increasing more slowly than with Private Insurers, contrary to some of the policy proposals that have been put forth in recent years. According to the study of CMS data between 2006 and 2017, “Medicare and Medicaid spending per enrollee grew 2.4 percent per year and 1.6 percent per year, respectively, compared to...

Donna White
Share
News

News Briefs

[vc_row][vc_column][rev_slider_vc alias="news"][/vc_column][/vc_row][vc_row][vc_column width="1/2"][vc_column_text] The beginning of February has seen multiple news stories come across the wire. We did a round up of the top stories over the last week. Senate Health Committee reviews proposal for provider dispensed generic drugs This week Dr. Josh Umbehr, co-founder of Atlas MD, proposed before the Senate this week that by cutting out the middle man and allowing providers to not only prescribe, but dispense generic drugs would...

Donna White
Share