The Insulin-PBM Rebate Kickback Scheme Appears to Be Coming to an End
Last year, on March 3, 2022, in what I believe was a fantastic accomplishment relatively early in Aaron Kowalski ' s tenure as CEO, the JDRF and Civica, Inc. (via the company ' s CivicaScript operating unit) jointly announced Civica ' s intention to commercialize biosimilars of the three bestselling insulin analogues at an affordable price of $30/vial or $55/box of five insulin pens. The Civica press release can be seen athttps://www.businesswire.com/news/home/20220303005321/en/Civica-to-Manufacture-and-Distribute-Affordable-Insulin/ and a concurrent press release from JDRF can be seen athttps://www.prnewswire.com/news-rel...
Source: Scott's Web Log - March 14, 2023 Category: Endocrinology Tags: Eli Lilly and Company 2023 Civica CivicaRx CivicaScript drug prices FTC insulin insulin prices JDRF Novo Nordisk Novo Nordisk Pharma Source Type: blogs
Why we don't get what we pay for
Before I take up the subject of this post, a note about commenting. I wish I could publish more comments but most of them are ridiculous or off topic. For example, I wrote a post about Kanye West. He was the subject of the post. It was about him. And I get a comment to the effect of Why won ' t I talk about Black antisemitism? WTF? I post about the high cost of health care in the U.S. and I get a comment about total federal revenues and the federal budget deficit. BTW, obviously federal revenues will generally increase over time because the economy and the population grow. Also you have to adjust for inflation. But that ' ...
Source: Stayin' Alive - March 10, 2023 Category: American Health Source Type: blogs
President Biden ’s Budget Misses the Mark
Romina Boccia and Dominik LettPresident Biden finally released hisannual budget blueprint for fiscal year 2024, more than a month late. This year’s presidential budget is filled with excessive spending, higher taxes, and misguided policies.The President proposes to reduce deficits by $3 trillion over the next ten years. That goal, while moving in the right direction, falls far short of the $8 trillion in deficit reduction that ’s needed to stop federal debt from growing to a new record‐high. Moreover, the President’s plans to reduce deficits also put the cart before the horse by primarily raising taxes to clo...
Source: Cato-at-liberty - March 9, 2023 Category: American Health Authors: Romina Boccia, Dominik Lett Source Type: blogs
Aledade Adds More Than 450 New Practices for 2023, Making It the Largest Network of Independent Primary Care in the Country
Company Also Announces Its Second Acquisition – Value-Based Care Analytics Company Curia
Aledade, the nation’s largest network of independent primary care, today announced that it added more than 450 primary care practices, including nearly 60 health centers, to its nationwide network for 2023, the most of any value-based care practice network. The company continues to be the largest network of independent primary care in the country, with more than two million patients covered by more than 150 value-based contracts across Medicare, Medicare Advantage, Medicaid and commercial payers. Aledade works with more than 1,...
Source: EMR and HIPAA - March 7, 2023 Category: Information Technology Authors: Healthcare IT News Tags: Ambulatory Health IT Company Healthcare IT AI Aledade Artificial Intelligence CACP Comprehensive Advance Care Planning Curia Dr. Farzad Mostashari Foundry.ai Health IT Acquisitions Healthcare M&A Jim Manzi Medicaid Medicare Source Type: blogs
Featured Health IT Job: Healthcare Data Analyst
We like to regularly feature a healthcare IT job that might be of interest to readers. Today, we’re featuring the Healthcare Data Analyst position that was recently posted on Healthcare IT Central. This position was posted by New York eHealth Collaborative and is in New York.
Here’s a description of the position:
New York eHealth Collaborative (NYeC) is a not-for-profit organization working in partnership with the New York State Department of Health to improve healthcare by collaboratively leading, connecting, and integrating health information exchange across the State.
Founded in 2006 by healthcare leaders,...
Source: EMR and HIPAA - March 1, 2023 Category: Information Technology Authors: Health IT Jobs Tags: Career and Jobs Healthcare IT Data Analyst Health IT Jobs Healthcare Data Analyst Healthcare IT Jobs Job Seekers New York eHealth Collaborative New York Health IT Jobs NYeC Source Type: blogs
CMS: anti-amyloid drug Leqembi (lecanemab) doesn ’t meet the “reasonable and necessary” standard required for wider Medicare coverage
CMS Sticks to Sharply Limited Coverage of New Alzheimer’s Drug, Leqembi (Managed Healthcare Executive):
For now, CMS (Note: Centers for Medicare & Medicaid Services) is sticking to the coverage decision it made for Aduhelm (aducanumab) and applying it Leqembi (lecanemab). The decision limits Medicare coverage of the two Alzheimer disease’s drugs to Medicare beneficiaries who have enrolled in clinical trials of the drugs
The decision, which was announced in a press release yesterday, was denounced in strong language by the Alzheimer’s Association.
“CMS’ role is to provide health care coverage” said Joanne Pi...
Source: SharpBrains - February 28, 2023 Category: Neuroscience Authors: SharpBrains Tags: Brain/ Mental Health aducanumab Aduhelm Alzheimer's drug Alzheimers-Association amyloid CMS dementia FDA lecanemab Leqembi Medicare monoclonal antibodies Source Type: blogs
As I was saying
I seldom link to the NYT (or, as Atrios calls it, " that f.ing newspaper) because it ' s paywalled. But I believe you get three free reads a month, and in any case I ' m going to pull the good stuff fromKrugthulu ' s latest.It ' s about this:Many House Republicans arereportedly listening to Russell Vought, Donald Trump ’s former budget director, who has a new think tank and has been circulating abudget proposal titled “A Commitment to End Woke and Weaponized Government,” which purports to show a way to balance the budget without touching Medicare and Social Security. The document uses the word “woke” 77 tim...
Source: Stayin' Alive - February 25, 2023 Category: American Health Source Type: blogs
Weekly Roundup – February 25, 2023
Welcome to our Healthcare IT Today Weekly Roundup. Each week, we’ll be providing a look back at the articles we posted and why they’re important to the healthcare IT community. We hope this gives you a chance to catch up on anything you may have missed during the week.
Making Machine Learning Work With HIPAA. Andy Oram chatted with Abhi Sharma at Loyal about what it takes to make HIPAA-compliant chatbots. Data masking and separate databases for each client are essential, he learned. So is customizing the chatbot for each client and making responses sound natural. Read more…
Applying AI to Healthcare Decision-Maki...
Source: EMR and HIPAA - February 25, 2023 Category: Information Technology Authors: Brian Eastwood Tags: Healthcare IT Healthcare IT Today Weekly Roundup Source Type: blogs
How to Discover Better Insurance Coverage, Together
Streamlining and improving revenue is hyper-important for healthcare organizations right now. One challenge is finding the right patient payer information. Technology can help organizations identify more billable insurance coverage for self-pay patients, maximizing revenue, increasing efficiency and improving patient experience.
The following is a guest post from Inovalon.
Many healthcare providers find themselves wondering whether a revenue cycle management (RCM) partner would benefit their organizations. When providers can find the right partners – partners that add value to the organization’s industry expertise by d...
Source: EMR and HIPAA - February 23, 2023 Category: Information Technology Authors: Guest Author Tags: Administration Ambulatory Health IT Company Healthcare IT Hospital - Health System Revenue Cycle Management billable coverage Healthcare Scene Featured Inovalon insurance discovery Medical Bills patient co-pays patient deductibles Source Type: blogs
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Information on voluntary disenrollment rates for Medicare Advantage plans could help beneficiaries make decisions about choosing plans during election periods.
(Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - February 22, 2023 Category: International Medicine & Public Health Authors: Janet P. Sutton Source Type: blogs
Fixing Medicare Advantage Payments
This article looks at the problem from the other side. Here, we adopt a position sympathetic to the hurdles facing Medicare Advantage plans and look at how they are trying to improve the quality of data.
A bit of cynicism is deserved here. Consultants who offer services to healthcare providers often cite “improving the quality of diagnoses” as a code phrase for “extracting the maximum payment you can for a given patient.”
I talked recently to Meleah Bridgeford, senior director of risk adjustment analytics at Episource, about how their analytics and billing solution can improve the quality of submiss...
Source: EMR and HIPAA - February 22, 2023 Category: Information Technology Authors: Andy Oram Tags: Administration Analytics/Big Data Health IT Company Healthcare IT Regulations Revenue Cycle Management CMS Episource Healthcare Billing Medical Billing medical coding Medicare Medicare Advantage Medicare Audits Upcoding Source Type: blogs
Featured Health IT Job: Lead Data Architect – Healthcare
We like to regularly feature a healthcare IT job that might be of interest to readers. Today, we’re featuring the Lead Data Architect – Healthcare position that was recently posted on Healthcare IT Central. This position was posted by Vytalize Health and is remote in the US.
Here’s a description of the position:
Lead Data Architect – Healthcare (Remote)
About Our Company
Vytalize Health is a leading value-based care platform for seniors that has raised over $70 million in financing from top healthcare investors. We partner with primary care practices and power them through bold financial incentives...
Source: EMR and HIPAA - February 22, 2023 Category: Information Technology Authors: Health IT Jobs Tags: Career and Jobs Healthcare IT Data Architect Health IT Jobs Healthcare IT Jobs Job Seekers Remote Jobs Vytalize Vytalize Health Vytalize Health Jobs Source Type: blogs
CVS Health to Acquire Oak Street Health
Acquisition further advances CVS Health’s care delivery strategy for consumers
CVS Health® (NYSE: CVS) and Oak Street Health (NYSE: OSH) have entered into a definitive agreement under which CVS Health will acquire Oak Street Health in an all-cash transaction at $39 per share, representing an enterprise value of approximately $10.6 billion.
Oak Street Health is a leading multi-payor, value-based primary care company helping older adults stay healthy and live life more fully. With an innovative care model and technology platform designed to deliver consistently superior outcomes and patient experiences, Oak Street Healt...
Source: EMR and HIPAA - February 20, 2023 Category: Information Technology Authors: Healthcare IT News Tags: Ambulatory Health IT Company Healthcare IT Centerview Partners Credit Suisse Securities (USA) LLC CVS CVS Health Dechert LLP Direct to Consumer Healthcare DTC Healthcare EBITDA EPs General Atlantic LLC Health Care Delivery Organi Source Type: blogs
Matthew ’s health care tidbits: Medicare Advantage is now a provider fracking contest
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
Yes it’s time to talk Medicare Advantage (MA). It’s been a huge couple of weeks for the world of MA. On the commercial side, CVS bought the biggest pure play MA provider, Oak Street Health for $10bn. This pissed me off as if they paid $2 a share more I’d have made a profit on the stock I foolishly bought “on a dip” in 2021.
But this amazed many of us on ...
Source: The Health Care Blog - February 20, 2023 Category: Consumer Health News Authors: matthew holt Tags: Matthew Holt The Business of Health Care ChenMed CMS CVS Humana Medicare Advantage Oak Street Health UnitedHealth Group Source Type: blogs
The Business of Diabetes: Dexcom Spends Big on Super Bowl Ad to Hype New G7 Claiming " Feels Like Magic " ; But the Ad Isn't Magic
This month was the U.S. NFL ' s Super Bowl #57; the two teams which played one another were the Philadelphia Eagles and the Kansas City (Missouri) Chiefs, and the Kansas City Chiefs were the winners in a close game throughout. For a moment, let ' s just overlook that Kansas City ' s team name is rooted in the same racism against indigenous native Americans (after all, the team ' s logo is an arrowhead, which was created by native Americans) the same view ultimately forced the old Washington Redskins to change the team name to the Washington Commanders), and let ' s instead focus on this year ' s game advertising. But Misso...
Source: Scott's Web Log - February 18, 2023 Category: Endocrinology Tags: Business of Diabetes 2023 Abbott Advertising business strategy CGM CGMS Dexcom Freestyle Libre Super Bowl Source Type: blogs
