CMS is staking a lot on accountable care organizations reducing spending while improving care for Medicare beneficiaries. A snapshot of early experience finds that 29 out of 114 ACOs generated enough savings to get some back from CMS. According to CMS, overall $380 million was saved. But less than half the programs had lower spending than projected and among Pioneer, or more experienced ACOs, performance was not much better. Many providers are undecided on seeking ACO status, since the $80 per patient savings don't go very far to paying for the immense additive costs of becoming one.
According to a Medical Economics survey, the primary concerns among physicians are reimbursement, paperwork, health care reform and outside interference with their practice decisions and many are frustrated by health information technology systems.
A survey of providers and payers suggests that health information exchanges are in trouble, with most respondents finding they offer poor connectivity and have flawed business models.
ZappRx, which aims to speed up the prescribing and ordering of specialty drugs, has received one million in financing from investors that include GlaxoSmithKline's venture fund.
A brief note from PWC's Health Research Institute assesses the impact on drug manufacturers from the health exchanges, suggesting that there maybe a benefit from more people having insurance, but the size of the benefit may depend on the nature and extent of the drug benefit.
A doctor writing in JAMA suggests that there are six misleading words associated with evidence-based medicine--"there is no evidence to suggest"--and that these words can make people think that a particular treatment is or isn't efficacious or safe when there really just isn't research on the point.
Gilead's new Hep C drug costs $84,000 for a 12 week course of treatment and PBMs and payers are determined not to pay it. The latest in the battles over the frightening rise in specialty drug use and spending.
With the proliferation of quality measures, a timely research piece in Health Affairs suggests that out of 13 common AHRQ indications, 7 account for 93% of the total benefits of compliance with the measures. The number of measures could be cut back on without affecting quality and lowering compliance costs and confusion.
Health Catalyst, which sells data warehousing and analytics services to providers and payers, raised another $41 million in financing to assist in the growth of the company.
Successful techniques for better medication adherence are presented in a JAMA viewpoint, including patient education and counseling, self-monitoring and cost interventions.
A JAMA viewpoint discusses how to reconcile evidence-based medicine and patient preferences, with a focus on the importance of recognizing informed patient choices, even when they may conflict with the best research evidence represented by a guideline.
A Wall Street Journal article discusses the reaction to the Veteran's Administration decision to let nurse practitioners treat patients without physician supervision, which many doctors oppose, largely in a bid to protect their turf.
Quantum Health, which offers care coordination and patient navigation services, has received an undisclosed amount of financing from GE and other investors.
MediSwipe, which provides software and equipment to the medical and recreational marijuana markets, has received a $1.1 million investment from a private equity fund. To be blunt, not a high amount, but enough to keep them from going to pot.
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.