Health Care Cost

The proposed Medicare High-Value Drug List Model, also known as the Medicare $2 Drug List, could have modestly reduced out-of-pocket costs for 38% of beneficiaries if implemented in 2021.

"As CMMI continues to test new equity adjustments, it is important that changes be grounded in scientific principles with extensive testing and validation to ensure the tightest linkage to social needs and health outcomes for underserved communities across the entire US," authors wrote.

The Center on Health Equity & Access covers news spanning health policy, politics, and clinical research, while featuring interviews with expert insights.

The authors examine how insurer and patient out-of-pocket payments for advanced prostate cancer differ by drug and health plan type and describe the relationship between these payments and utilization.

More than 25 million people lost their Medicaid coverage during the unwinding process conducted by all states following the pandemic.

The US health care system is underperforming despite high spending, and reform is needed in areas like insurance coverage, primary care, and equity to improve overall health outcomes and efficiency.

The Inflation Reduction Act was signed into law on August 16, 2022, and the debate over its Medicare-related benefits and impact on the prescription drug market has been raging ever since.

This commentary introduces Catalyst for Payment Reform’s and the Employers’ Forum of Indiana’s new campaign, Price Crisis, which will mobilize individuals, employers, and policy makers with evidence, guidance, and resources to take meaningful actions.

Results from a new study link inpatient food insecurity with longer hospitalization and greater chances of readmission.

From the presidential debate, ongoing conferences, and health care deserts in rural America, the Center on Health Equity & Access covers the latest news on population health, managed care, and health policy.

Panelists discussed how the Inflation Reduction Act and the Enhancing Oncology Model are impacting value in cancer care and access to treatment.

With the advances in cancer care, focus has mostly been on lamenting the high cost of these innovations instead of making patients and populations healthier, said A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design at the University of Michigan.

Jennifer Green, MD, of Duke University, explained that while CMS-negotiated drug prices under the Inflation Reduction Act (IRA) may not immediately lower patients' costs, they could improve access to expensive medications.

During the presidential debate, former President Donald Trump and Vice President Kamala Harris shared their differing visions for the future of the Affordable Care Act (ACA).

Ali Khawar, Employee Benefits Security Administration, US Department of Labor, believes the final rule will be a benefit to employers and health plans that are trying to do the right thing and offer robust mental health benefits or substance use benefits.

Ken Cohen, MD, of Optum Care, advocates for glucagon-like peptide 1 (GLP-1) tiering for patients with diabetes based on comorbidities, like body mass index (BMI) and cardiovascular disease (CVD).

The Center on Health Equity & Access provides the latest news, research, and expert opinions on the state of equity in health care.

Using artificial intelligence (AI) in breast cancer screenings in the United Kingdom could be cost-effective and improve health outcomes after identifying more cancers.

Ian Neeland, MD, of University Hospitals and Case Western Reserve University, recommended a team-based, comprehensive approach to managing diabetes and its related complications.

Manisha Jhamb, MD, MPH, of the University of Pittsburgh Medical Center (UPMC), is excited about CMS's negotiated drug prices under the Inflation Reduction Act (IRA) for patients with kidney disease; conversely, she highlights the challenge of low kidney disease awareness.

An analysis on the state of pharmaceutical drug pricing revealed that, despite rebates, consumers' out-of-pocket costs have grown faster than their insurers' prices.

Ty J. Gluckman, MD, FACC, FAHA, of Providence St. Joseph Health, reacted positively to CMS' drug price cuts under the Inflation Reduction Act, but he also expressed concerns about the potential future impact on drug innovation.

Analysis of 2012-2021 commercial claims demonstrates that spending growth was concentrated among the highest spenders and there was increasing subsidy across enrollees through cost-sharing design.

A heart failure program with a multidisciplinary team provides statistically significant improvements, and 2 countries determine the current prices of semaglutide are not cost-effective for secondary prevention of cardiovascular disease in patients with obesity, according to abstracts at the European Society of Cardiology (ESC) Congress 2024.

The obesity epidemic is a global crisis, with experts from around the world emphasizing the importance of short-term strategies, long-term solutions, and multidisciplinary collaboration as they advocate for the heart health of their patients.

Jason Romancik, MD, a board-certified hematologist at Emory Winship Cancer Institute, discusses the current treatment landscape in aggressive lymphoma and drivers of high care costs.

Providing health care for Olympic athletes can put a heavy burden on both the competitors and their doctors to deliver that care and to pay for such care in the long term.

Eli Lilly has introduced discounted single-dose vials of tirzepatide (Zepbound) for self-pay patients with obesity to increase accessibility.

PfizerForAll aims to help improve health care by offering telehealth services, prescription services, vaccination scheduling, and savings programs.

Thyme Care welcomes its new senior vice president to lead initiatives in value-based oncology care.