The HHS Office of Inspector General has issued a report recommending that Congress or CMS reduce payments for hospital outpatient surgeries to the same rates as those for freestanding surgery centers, which could save billions a yearn for CMS and beneficiaries.
Catamaran, a large PBM, has issued its version of drug trend reporting, showing a per member per month trend of 2.4% in 2013 versus 2.6% in 2012. Upward pressure is almost all from brand drug unit price increases and greater use and cost of specialty drugs, offset by continued generic expansion. Catamaran is anticipating that trend could be as high as 5% in 2014, 6% in 2015 and 7.7% in 2016, driven by rising specialty use.
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 khroche@healthy-skeptic.com.
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 khroche@healthy-skeptic.com.