Why I’m doing one of the riskiest surgeries in medicine
If the act of organ donation is among humanity’s greatest gifts, what can be said of living donors who undergo surgery to extend and improve the life of another? It’s truly a courageous and inspiring sacrifice.
I was honored recently to be able to perform my first living-donor liver transplant. Jason Clark, 28, donated about 60 percent of his liver to his father, Lynn, 57, who had been sick for many years after contracting Hepatitis C from a blood transfusion following a car accident in 1980. Lynn was in end-stage liver failure and yet was nowhere near the top of the waitlist. The people closest to Lynn watched helples...
Source: Kevin, M.D. - Medical Weblog - May 4, 2016 Category: Journals (General) Authors: Robin Kim, MD Tags: Physician Surgery Source Type: blogs
IMS Releases 2016 Report on Prescription Drug Spending – Net Price Growth 2.8% in 2015
Discussion on Medicare Part B Drug Payment Model Demonstration (Source: Policy and Medicine)
Source: Policy and Medicine - May 1, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
This won't end the opioid epidemic . . .
. . . but it might help. The CDC has come up with new guidelines for opioid prescribing in outpatient care which are heavily promoted in the leading medical journals. (The link is to NEJM, which proffers it for free to the subscriptionless rabble.)The story of how we got where we are is pretty well known, I think. But I'll recap it for convenience. Chronic pain (CP) is the most prevalent and expensive health condition in the United States, estimated to cost up to $635 billion per year in health care costs and lost productivity. Often pain is from osteoarthritis or other identifiable physical causes, but as I have discussed...
Source: Stayin' Alive - April 21, 2016 Category: American Health Source Type: blogs
Designing Successful Bundled Payment Initiatives
Bundled payment initiatives are a growing form of value-based payment. The use of bundled payments can align reimbursement with the health care triple aim of improving experience of care, improving population health, and reducing total costs of care. Successful bundled payment initiatives have demonstrated an ability to both lower costs and improve health care quality.
However, bundled payments also change financial incentives because the model shifts risk from payers to providers. This may result in unintended consequences, including underutilization of needed but costly services or avoiding caring for the sickest patient...
Source: Health Affairs Blog - April 20, 2016 Category: Health Management Authors: Michael Ciarametaro and Robert Dubois Tags: Costs and Spending Featured Insurance and Coverage Medicare Payment Policy Population Health Quality Bundled Payments chronic disease High-Cost Patients triple aim Source Type: blogs
Quality Measure Core Set Implementation Plan
Discussion on Medicare Part B Drug Payment Model DemonstrationMedPAC Votes for Sweeping Revisions to Medicare Part DMedPAC Meeting on Part B Drug Payment Policy (Source: Policy and Medicine)
Source: Policy and Medicine - April 17, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Milestones On The Path To Population Health
Use of the term “population health” has surged in recent years. Much of this enthusiasm has been driven by the idea that health reform would restructure incentives and unite the priorities of health care and public health. In practice, however, population health is often invoked by various stakeholders using different definitions: in health care, it usually refers to managing the health and cost outcomes of a defined patient population attributed to a health care system. Meanwhile, in public health, population health encompasses the aggregate health status of all people in a given geographic area.
Divergent definitions...
Source: Health Affairs Blog - April 11, 2016 Category: Health Management Authors: Dave Chokshi and Nicholas Stine Tags: Equity and Disparities Featured Population Health Public Health Quality chronic conditions culture of health Diabetes hypertension New York City New York City Health Hospitals Social Determinants of Health Source Type: blogs
Is pharma industry too meek on pricing?
What were we thinking?
The biopharmaceutical industry has been under attack for some time for the high and rising prices of its products. Pressure has increased recently with the arrival of costly medications for oncology, hepatitis, high cholesterol and more. Expect even further pressure as more specialty drugs are introduced, and then really significant pushback once seriously costly innovations such as gene therapy come online.
I’ve noticed that the pool of people complaining about drug pricing is widening. Now, even doctors are picking up the megaphone. For example, the American College of Physicians (ACP...
Source: Health Business Blog - April 1, 2016 Category: Health Management Authors: dewe67 Tags: Pharma Policy and politics Source Type: blogs
Specialty Pricing Drugs: How Did We Get Here and Where Do We Go
Conclusion
One opportunity for the pharmaceutical industry to improve its image is to step up efforts to provide drug payment assistance to lower-income patients. Little data actually exists as to how many patients actually have difficulty affording their drugs, and if companies can demonstrate that the number is low, that might be a response to the pricing criticism.
Dr. Stossel calls for all stakeholders to participate in finding solutions, including physicians, pharmaceutical companies, and insurers. As Dr. Stossel states in his publication, "imposition of drug price controls in the US will compromise access to bett...
Source: Policy and Medicine - March 31, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
HHS Marks Sixth Anniversary Of Affordable Care Act
Implementing Health Reform. March 23, 2016 marks the sixth anniversary of the signing of the Affordable Care Act. This week the Department of Health and Human Services (HHS) is releasing a series of blog posts publicizing the successes of the ACA. On March 22, the HHS Assistant Secretary for Planning and Evaluation released a report on Health Care Spending Growth and Federal Policy under the ACA.
The report notes that national health care spending per person increased moderately at a rate of 4.3 percent in 2014. Much of this growth was attributable to the high costs of covering the newly insured, which may in part be attr...
Source: Health Affairs Blog - March 22, 2016 Category: Health Management Authors: Timothy Jost Tags: Costs and Spending Drugs and Medical Technology Following the ACA Insurance and Coverage Medicaid and CHIP Medicare Quality ACA gains ASPE Medicare Part D Prescription Drugs Source Type: blogs
HHS Marks Sixth Anniversary Of Affordable Care Act (Update)
Implementing Health Reform (March 23 update). Two and a quarter years into the implementation of the health insurance marketplaces we are nearing, but have not yet reached, the fully electronic systems envisioned when the ACA was signed into law six years ago. This is evidenced by two guidances which the Centers for Medicare and Medicaid Services (CMS) released on March 22, 2016.
In the first guidance, CMS announced that it is delaying for one more month the full transition to a “policy-based payment system” for paying insurers advance premium tax credit and cost-sharing reduction payments.
Through the end of 2015, CM...
Source: Health Affairs Blog - March 22, 2016 Category: Health Management Authors: Timothy Jost Tags: Costs and Spending Drugs and Medical Technology Following the ACA Insurance and Coverage Medicaid and CHIP Medicare Quality ACA gains ASPE GAO Medicare Part D Prescription Drugs small employer Source Type: blogs
A New Role For The Veterans Health Administration
The Veterans Health Administration (VHA) is transforming into a major health care payer in addition to its role as a provider. In 2014, in response to scandals in the Department of Veterans Affairs (VA) related to access to care, Congress opened the door to a marked expansion of VA-paid care in the community with its “Choice” program and a $10 billion appropriation. A 2015 law then mandated consolidation of the VHA’s many established community care programs into one – the Veterans Choice Program.
The VA, with forward-thinking leadership, responded with an ambitious plan to alter its approach to care. The plan w...
Source: Health Affairs Blog - March 18, 2016 Category: Health Management Authors: Joel Kupersmith Tags: Featured Insurance and Coverage Medicare Congress Veterans Veterans Choice Program Veterans Hospitals Veterans' Health Care Source Type: blogs
Congress Has a Drug Problem
By BRIAN KLEPPER
The Congressional committee that recently demanded Martin Shkreli’s appearance must have hoped to spotlight a smug jerk responsible for the outrageous prescription drug pricing that we’re all up against. Of course there are lots of Shkrelis running drug companies, but most are shrewder and less brash, and might not make for such good theater.
Rep. Elijah Cummings (D-MD), one of the Committee’s questioners, seemed to think that his witness could move healthcare forward by disclosing the machinery of the drug sector’s excesses. “The way I see it, you could go down in history as the poster boy fo...
Source: The Health Care Blog - March 16, 2016 Category: Consumer Health News Authors: Simon Nath Tags: Featured THCB Brian Klepper Pharma Shkreli Source Type: blogs
MKSAP: 55-year-old man with hepatitis C virus (HCV)
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 55-year-old man is evaluated in follow-up after a recent routine screening for antibody to hepatitis C virus (HCV) was positive. His medical history is unremarkable; he has not used illicit drugs or had any history of blood transfusions. He currently feels well and takes no medications.
Vital signs and physical examination are normal.
Laboratory studies reveal a positive HCV antibody test, but HCV RNA testing is negative. The serum alanine aminotransferase level is normal.
Which of the following is the most ap...
Source: Kevin, M.D. - Medical Weblog - March 12, 2016 Category: Journals (General) Authors: mksap Tags: Conditions GI Source Type: blogs
CMS Releases Final 2017 Letter To Issuers In The Federally Facilitated Marketplaces (Updated)
Implementing Health Reform (March 3 update). On March 3, 2016, the Office of the HHS Assistant Secretary for Planning and Evaluation (ASPE) announced that the ACA has resulted in gains in health insurance coverage of 20 million adults through February 22, 2016. This includes 2.3 million young adults who gained coverage under the ACA provision allowing young adults to remain on their parents’ coverage through age 26, and 17.7 million non-elderly adults who have gained coverage between the beginning of open enrollment in October 2013 and the present. The report shows continued progress since ASPE released its last estimat...
Source: Health Affairs Blog - March 3, 2016 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage Alaska Medicaid expansion QHPs Supreme Court Source Type: blogs
