Each year CMS issues proposed, and ultimately final, rules relating to reimbursement for various categories of providers in the next year. The 2012 rules have a wealth of background and other information in them, including significant detail on the increasingly important quality measurement programs.
A lot of the work on geographic variation in spending has been done on the Medicare population. New research published in Health Affairs examines variation in Medicaid spending for the disabled population and finds significant differences based on both volume and unit prices.
Research published in the New England Journal of Medicine examines early results from the Massachusetts Blue Cross plan’s global budgeting program, finding very modest health spending reductions and small changes in quality.
The National Venture Capital Association released statistics regarding second quarter of 2011 venture capital activity. While some aspects of exits, fund-raising and investing have improved from the depth of the recession, levels are still lower than optimal to facilitate overall economic growth.
The dog days of summer bring yet another scorching hot Potpourri with a smorgasbord of data, including metabias in randomized clinical trials, the practice of defensive medicine, the status of HIEs, retail pharmacy drug costs and pricing and spending on medical devices.
The FDA released a draft guidance on how it will regulate mobile and wireless healthcare devices and applications, which to a large extent follows proposed guidance from the mHealth Regulatory Coalition. The guidance may facilitate growth of this industry segment.
An AHRQ Statistical Brief looks at the most costly health conditions for 2008. They are about what you would expect, with heart disease and cancer leading the way. Women and men have the same top ten expensive conditions, but in slightly different order.
A recent report from the NIHCM details national spending, showing that a few patients account for a lot of costs and that hospitals are the largest source of spending growth. Unit price increases are more important than utilization in explaining spending rises. Insurance administrative costs have actually declined as a percent of spending.
AHRQ releases a Statistical Brief on Hospital-Acquired Conditions, which are a focus of quality improvement, including unreimbursed never events. The Brief details types of conditions across several payers, including Medicare.
A mid-summer’s evening (or weekend) Potpourri, but no heated discussion here, just soothing nuggets of knowledge, including use and misuse of PCI, how to measure blood pressure, CMS and telemedicine, preventing falls, copying and pasting EHR notes, and physicians attitude to work and compensation.
Our final drug report post discusses releases from Express Scripts, the Pharmacy Benefit Management Institute and ESI’s PMSI division, which focuses on workers’ compensation pharmacy. Express Scripts emphasizes behavioral aspects of trend management and the PBMI report examines drug benefits from the employer perspective.
Today’s drug trend reports come from Medco and CVS Caremark, two of the largest pharmacy benefit managers. Both experienced relatively low overall trends and both anticipate specialty drug management being the primary challenge in the years ahead.
Our next set of drug reports deals with specialty drugs, the most expensive and fastest growing category, and one which has bedeviled payers but many of the drugs are covered under medical benefits. The reports detail usage trends and describe payer management strategies in detail.
The first analysis of a weeklong series on recent reports related to aspects of the pharmaceutical industry covers IMS’ report giving projections on aspects of global drug use and spending through 2015 and SureScripts release of the most recent statistics on eprescribing use.
Our current Potpourri features Google’s dropping of its PHR, the AMA’s report on insurer claims paying, the role of health advocacy groups, employer’s intentions in regard to offering health coverage, drug approval in the US versus Europe and the use of a checklist to improve quality in the ICU.
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
© 2024 Healthy Skeptic.
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