Price tag for a questionable Alzheimer ’s treatment: $109,000 per patient, per year. Unclear yet: For how many years?
The real costs of the new Alzheimer’s drug, Leqembi — and why taxpayers will foot much of the bill (CBS News):
The first drug purporting to slow the advance of Alzheimer’s disease is likely to cost the U.S. health care system billions annually even as it remains out of reach for many of the lower-income seniors most likely to suffer from dementia.
Medicare and Medicaid patients will make up 92% of the market for lecanemab, according to Eisai Co., which sells the drug under the brand name Leqembi. In addition to the company’s $26,500 annual price tag for the drug, treatment could cost U.S. taxpayers $82,500 per pati...
Source: SharpBrains - August 2, 2023 Category: Neuroscience Authors: SharpBrains Tags: Brain/ Mental Health Alzheimers-disease amyloid plaques brain hemorrhaging brain scans brain swelling dementia lecanemab Leqembi Medicaid Medicare PET-scan taxpayers Source Type: blogs
---
To address the youth mental health crisis, extend the behavioral health workforce by using digital mental health technology, but it should be covered by Medicaid.
(Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - July 26, 2023 Category: International Medicine & Public Health Authors: Kacie Kelly, Lindsey Engelman, Solome Tibebu, Sara Federman Source Type: blogs
Is More Physician-Owned Hospitals the Solution to our Health Cost problem?
BY JEFF GOLDSMITH
Robert Frost once said, “Home is where, when you have to go there, they have to take you in.”
Increasingly, in our struggling society, that place is your local full service community hospital. During COVID, if it wasn’t your local hospital standing up testing sites, pumping out vaccinations and working double overtime helping patients breathe, we would have lost several hundred thousand more of our fellow Americans.
But it wasn’t just COVID where hospitals leaped into the breach. As primary care physicians’ practices collapsed from documentation overburde...
Source: The Health Care Blog - July 26, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: The Business of Health Care Affordable Care Act COVID Jeff Goldsmith Physician-Owned hospitals Source Type: blogs
Health Care, Disagree Better
BY KIM BELLARD
On one of the Sunday morning news programs Governors Spence Cox (UT) and Jared Polis (CO) promoted the National Governors Association initiative Disagree Better. The initiative urges that we practice more civility in our increasingly civilized political discourse. It’s hard to argue the point (although one can question why NGA thinks two almost indistinguishable, middle-aged white men should be the faces of the effort), but I found myself thinking, hmm, we really need to do that in healthcare too.
No one seems happy with the U.S. healthcare system, and no one seems to have any real ideas about...
Source: The Health Care Blog - July 25, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Health Policy Health insurance Healthcare Access Healthcare system Kim Bellard Source Type: blogs
---
State Medicaid agencies can play a leading role in driving decarbonization efforts in the health care system.
(Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - July 20, 2023 Category: International Medicine & Public Health Authors: Paul Shattuck, Corrie Haley, Emily Cross Source Type: blogs
Preventive Medicine is the Key to Value-Based Care
The following is a guest article by Dr. Ed Cladera, Medical Director at AristaMD
We’re amid a massive provider shortage, and it’s only getting worse. According to data from the Association of American Medical Colleges, the U.S. is on track to face a shortage of up to 124,000 physicians by 2034. As a result of being unable to access care, patients are pushing off routine health services. Neglected care comes with more complications down the line.
Studies have shown that preventative care decreases the incidence of disease and patient mortality, resulting in better care outcomes. Preventive medicine proactively identifie...
Source: EMR and HIPAA - July 18, 2023 Category: Information Technology Authors: Guest Author Tags: Clinical Communication and Patient Experience Health IT Company Healthcare IT Hospital - Health System AristaMD Association of American Medical Colleges Decreasing Costs Ed Cladera MD Improving Outcomes Medicaid Medicare PCP Prev Source Type: blogs
---
As Medicaid returns to normal, policymakers can utilize the tools at their disposal to prevent the potential reversal of children’s pandemic-era coverage gains.
(Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - July 17, 2023 Category: International Medicine & Public Health Authors: Sara Federman, Akeiisa Coleman Source Type: blogs
HHS Again Suspends Disbelief: The Medicaid Program Will Ignore the Greatest Health Threat to Medicaid Beneficiaries
BY DAVID INTROCASO
In May the Centers for Medicare and Medicaid Services (CMS) simultaneously published two proposed Medicaid rules (here and here) intended to improve moreover access and quality. Both discussed at length the agency’s commitment to “addressing health equity.” The first sentence in both identified health equity as a Medicaid program priority. The proposed “ensuring access” rule stated CMS “takes a comprehensive approach to . . . better addressing health equity issues in the Medicaid program.” CMS went on to state “we are working to advance health equity by designing, implementing,...
Source: The Health Care Blog - July 12, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Health Policy Biden Administration Centers for Medicare and Social Services Climate Change David Introcaso Source Type: blogs
Rationing Health Care
Lately we ' ve touched upon the absurd cost of medical services in the U.S. -- we spend twice as much as the next biggest spender and three or four times as much as others -- and we ' re less healthy for it. There are a few reasons for this, but here I ' m going to touch the third rail.In the United States, in contrast to other nations, if the FDA approves a treatment, insurance has to pay for it. The FDA does not consider cost, but only whether there is evident of clinical benefit that outweighs risks or (non-financial) harms. The definition of benefit and harm, and how to value them, is of course far from obvious, but we...
Source: Stayin' Alive - July 7, 2023 Category: American Health Source Type: blogs
Medicare Advantage Plans Can Leverage Virtual Cardiometabolic Care
BY RICHARD FRANK
By relying on virtual cardiometabolic solutions for continuous care, Medicare Advantage can produce better outcomes, curb costs, enhance member satisfaction — and improve Star ratings in the process.
By Richard Frank, MD, Chief Medical Officer Vida Health
Medicare Advantage is a hot market. Enrollment is steadily climbing and Medicare Advantage (MA) members now make up half the Medicare population. Though members keep rolling in, competition among MA plans is tight and turnover remains high. Nearly 16% of MA members switch plans at least once during their first year, while over a third end up sw...
Source: The Health Care Blog - July 5, 2023 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Health Policy Cariometabolic conditions Medicare Advantage Richard Frank Source Type: blogs
Matthew ’s health care tidbits: Time to get Cynical
Each time I send out the THCB Reader, our newsletter that summarizes the best of THCB (Sign up here!) I include a brief tidbits section. Then I had the brainwave to add them to the blog. They’re short and usually not too sweet! –Matthew Holt
Plenty of reason to worry about the future of American health care this week. The biggest for-profit hospital chain–HCA–was accused of aggressively pushing patients into hospice care, sometimes in the same room, in order to make their hospitality mortality numbers look better. Most of the leading benefits consulting companies were exposed as taking payments from PB...
Source: The Health Care Blog - June 26, 2023 Category: Consumer Health News Authors: matthew holt Tags: Health Policy Matthew Holt Babylon Health HCA Medicaid Medicaid Work Requirements PBMs UnitedHealth Group VBC Source Type: blogs
Like Don Quixote Chasing Windmills, I Aim to See Financial Remediation for Patients Still Suffering in a Predatory U.S Healthcare System
Sometimes, I feel (if you pardon the metaphor) a bit like Don Quixote chasing windmills with my efforts to see true financial remediation introduced in the predatory U.S. healthcare " system " (and I am glad to see that the term " predatory " is now being used by a growing number of medical doctors, which I think is great). I envision a type of financial remediation whereby patients will be able to get access to the care they need without having to face financial predators trying to pick their pockets with illegal discount bribes standing in the way of their getting access to things they need like insulin, CGM senors ...
Source: Scott's Web Log - June 25, 2023 Category: Endocrinology Tags: 2023 CGM Formulary Exclusion insulin PBM Source Type: blogs
Pomelo Care Secures $33M, Partners with Leading Health Plans, Employers and Academic Medical Centers to Deliver Value-Based Care and Improve Maternal and Newborn Health
Backed by Andreessen Horowitz and First Round Capital, Pomelo Care has Built an End-to-End, Value-Based Virtual Maternity Care Platform and is on Track to Cover 2M Lives this Year
Pomelo Care, a virtual medical practice that improves maternal and newborn health outcomes, today announced $33 million in Seed and Series A funding led by Andreessen Horowitz. The capital will fuel Pomelo’s continued partnership expansion with major health plans, including several Medicaid managed care organizations, employers and leading academic medical centers on the front lines of the national maternal health crisis.
Pomelo’s multispeci...
Source: EMR and HIPAA - June 23, 2023 Category: Information Technology Authors: Healthcare IT News Tags: Health IT Company Healthcare IT Adam Boehler Allen & Company LLC Andreessen Horowitz BoxGroup Center for Medicare and Medicaid Innovation CMMI Elevance First Round Capital Health IT Funding Health IT Fundings Health IT Investment Source Type: blogs
---
Study of Medicaid has been compromised by a lack of data, but there are opportunities for state and federal policymakers to improve analytic data going forward.
(Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - June 21, 2023 Category: International Medicine & Public Health Authors: Sarah Gordon, K. John McConnell, William L. Schpero Source Type: blogs
