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Sovaldi - a "Revolution" in Clinical Care, or in Marketing and Public Relations?
DiscussionWashington Post/ Kaiser Health NewsOn May 12, 2014, in an article on the dilemma the drug's US price of $1000/ pill presents to Medicare, Richard Knox wrote this about a patient with the infection:Previous drug treatments didn't clear the virus from Bianco's system. But it's almost certain that potent new drugs for hep-C could cure him. In other words, the article asserted that Sovaldi and similar drugs cure nearly everyone with hepatitis C, even those not cured by previous treatment.  ReutersOn May 20, 2014, in an article about how US health insurers are balking at the price of Sovaldi, was this statement b...
Source: Health Care Renewal - May 28, 2014 Category: Health Management Tags: evidence-based medicine Gilead health care prices manipulating clinical research Sovaldi You heard it here first Source Type: blogs

How States Can Expand Access To Palliative Care
Conclusion The policies discussed in this Blog post are intended to serve as a framework for policymakers and other stakeholders interested in doing more to support palliative care in their states. Here are a few considerations for those interested in exploring potential options: None of the policies and initiatives described above would have been possible without efforts from key stakeholders such as the state hospice and palliative care associations, and local funders, researchers, and advocates. Champions such as Colorado’s Center for Improving Value in Health Care (CIVHC), the Coalition for Compassionate Care of Cal...
Source: Health Affairs Blog - January 30, 2017 Category: Health Management Authors: Stacie Sinclair and Diane Meier Tags: End of Life & Serious Illness Long-term Services and Supports Medicaid and CHIP Payment Policy Quality California End-of-Life Care Palliative Care States Source Type: blogs

Hospital Closures Pose Challenges to Care
Empty beds in a hospital room. When 10-bed Nye Regional Medical Center, in west-central Nevada, closed abruptly in 2015, it meant that the residents of the former gold-mining town of Tonopah would have to drive about two hours across a hundred miles of desert roads to get to the nearest hospital.  The hospital’s CEO, Wayne Allen, didn’t sugar-coat it. “This is a decision that will ultimately jeopardize the health and well-being of our community and surrounding areas,” he said. Hospital closures over the last decade—most notably in rural areas and in pediatrics, but urban closures as well—have left patients wi...
Source: The Hospitalist - November 1, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Business of Medicine Career Pediatrics PHM22 Source Type: research

The Challenge Of Financing Sustainable Community-Based Palliative Care Programs
Since its publication in September 2014, there has been widespread praise for the Institute of Medicine (IOM) report, Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. It is a masterful piece of scholarship that summarizes the spectrum of issues facing palliative care. We hope the report will influence key decision-makers in medicine and various legislatures to promote the many changes outlined in the document, enabling palliative care to further improve the quality of life for those with advanced illness. Yet, despite the encyclopedic scope of Dying in America, the report did no...
Source: Health Affairs Blog - December 29, 2014 Category: Health Management Authors: Richard Bernstein and Karol DiBello Tags: All Categories End-of-Life Care Medicare Palliative Care Policy Quality Research Source Type: blogs

Can Startups Save Primary Care?
By ANDY MYCHKOVSKY Today, primary care is considered the bee’s knees of value-based care delivery. Instead of being viewed as the punter of the football team, the primary care physician (PCP) has become the quarterback of the patient’s care team, calling plays for both clinical and social services. The entire concept of the accountable care organization (ACO) or patient-centered medical home (PCMH) crumbles without financially- and clinically-aligned PCPs. This sea change has resulted in rapid employment or alignment to health systems, as well as a surge in venture capital being invested into the primary care space....
Source: The Health Care Blog - March 3, 2020 Category: Consumer Health News Authors: Christina Liu Tags: Health Tech Primary Care Start-Ups ACOs Adelade Andy Mychkovsky ChenMed Iora Health Oak Street Health One medical Population Health Privia Health Startups VillageMD Source Type: blogs

The U.S. Physician Shortage Is Only Going to Get Worse. Here Are Potential Solutions
If you’ve recently had to wait longer to see a doctor than you used to, that may not be entirely because of the COVID-19 pandemic. America is experiencing a physician shortage, and it’s only expected to get worse—a concerning situation that could lead to poorer health outcomes for many patients. Data published in 2020 by the Association of American Medical Colleges estimates that the U.S. could see a shortage of 54,100 to 139,000 physicians by 2033. That shortfall is expected to span both primary- and specialty-care fields. “The physician shortage can justly be characterized as a looming public-heal...
Source: TIME: Health - July 25, 2022 Category: Consumer Health News Authors: Elaine K. Howley Tags: Uncategorized freelance Health Care healthscienceclimate Source Type: news

Physician Payments Sunshine Act: Organizations Respond to CMS
  September 2nd marked the last day for comments on CMS’ proposed rule to eliminate the accredited continuing medical education (CME) exemption from Sunshine Act reporting.  In an overwhelming display of support for the exemption, over 800 comments were submitted encouraging the agency to either maintain or expand the current exclusion. -Total comments supporting maintenance or expansion of the CME exemption:  820 -Total comments supporting elimination of the CME exemption:  approximately 20 -Percentage of comments supporting the CME exemption: 98% We have followed this issue closely, and recentl...
Source: Policy and Medicine - September 8, 2014 Category: American Health Authors: Thomas Sullivan Source Type: blogs

Twenty-First Century Medicaid: The Final Managed Care Rule
With enrollment reaching 74 percent of all beneficiaries, it is clear that managed care has become the standard organizing mechanism for a Medicaid program whose welfare roots are behind it and that now functions as a principal source of public insurance. Given this broad national policy direction, a strong yet flexible regulatory framework for Medicaid managed care becomes a fundamental policy goal, particularly as state programs continue to evolve toward structures capable of managing care for the highest need populations. The modern contours of a 21st century regulatory framework finally came into full view on April 25 ...
Source: Health Affairs Blog - May 5, 2016 Category: Health Management Authors: Sara Rosenbaum Tags: Costs and Spending Featured Health Professionals Medicaid and CHIP Medicare Payment Policy Quality federal regulations MACRA MACRA final rule managed care organizations medical loss ratio Source Type: blogs

Quantifying Disparities in Accessibility and Availability of Pediatric Primary Care across Multiple States with Implications for Targeted Interventions
ConclusionsDisparities in availability are not as significant as disparities in accessibility. Opportunities to improve access to pediatric primary care vary by state. Generating specific recommendations for small areas is critical to enabling health policy decision makers to improvement access.
Source: Health Services Research - June 1, 2017 Category: Health Management Authors: Monica Gentili, Pravara Harati, Nicoleta Serban, Jean O'Connor, Julie Swann Tags: Research Article Source Type: research

Billing For Family Meetings as Critical Care in the ICU Explained.
Discussions:Critical care CPT codes 99291 and 99292 include pre and post service work. Routine daily updates or reports to family members and or surrogates are considered part of this service. However, time involved with family members or other surrogate decision makers, whether to obtain a history or to discuss treatment options (as described in CPT),may be counted toward critical care time when these specific criteria are met:The patient is unable or incompetent to participate in giving a history and/or making treatment decisions, and The discussion is necessary for determining treatment decisions.For family discuss...
Source: The Happy Hospitalist - August 8, 2013 Category: Internal Medicine Authors: The Happy Hospitalist Source Type: blogs

Inequities in < em > Chlamydia trachomatis < /em > Screening Between Black and White Adolescents in a Large Pediatric Primary Care Network, 2015-2019
Conclusions. Racial bias may affect screening practices and should be addressed in future interventions, given the critical need to increase population-level chlamydia screening.(Am J Public Health. 2022;112(1):135-143. https://doi.org/10.2105/AJPH.2021.306498).PMID:34936422 | PMC:PMC8713640 | DOI:10.2105/AJPH.2021.306498
Source: American Journal of Public Health - December 22, 2021 Category: International Medicine & Public Health Authors: Sarah Wood Jungwon Min Vicky Tam Julia Pickel Danielle Petsis Kenisha Campbell Source Type: research