Health Care Cost

Senator Joe Manchin, D-West Virginia, ended his opposition to the Inflation Reduction Act of 2022, paving the way for reductions in some Affordable Care Act subsidies and action on drug pricing; AbbVie’s Allergan agreed to pay more than $2 billion in opioid settlements; a study found vitamin D supplements do not reduce bone fracture risk.

Clinical trials and targeted agents do not appear to affect health care–related quality of life, however.

A team of investigators from across the United States investigated a potential connection between patients’ health insurance literacy and their reported financial hardship.

The Institute for Clinical and Economic Review (ICER) released the report, which supports the long-term value of betibeglogene autotemcel (beti-cel) for the treatment of beta thalassemia.

As part of the investigation into pharmacy benefit managers (PBMs), the Federal Trade Commission (FTC) should delve into how PBMs are impacting and fueling drug prices and set up guardrails to protect Americans, said Ted Okon, MBA, executive director, Community Oncology Alliance.

Long-term exposure to traffic-related air pollution was linked with higher annual emergency department and outpatient health care costs for older patients, particularly those with cardiovascular disease.

The budget allocates half of the money for the development of low-cost interchangeable insulin biosimilars and the other half for building an insulin manufacturing facility in the state.

Patients who experienced Clostridioides difficile infection had increased risks of mortality and hospital readmission, as well as greater length of stay and total hospital charges.

Increased atopic dermatitis severity in pediatric patients was associated with a greater physical, emotional, social, and economic impact on families.

An integrated primary care service may improve the health status of patients with severe chronic obstructive pulmonary disease (COPD) without increasing health care costs, according to a recent study.

This systematic review found that studies of case management interventions have adequate quality and, in many cases, show cost-effective or even cost-saving results.

Although prediabetes prevalence jumped 4.8 percentage points from 2010 to 2020, barriers to accessing diabetes prevention interventions persist, driven by cost, eligibility requirements, and data integration, leading to low participation rates.

The cost avoidance of heart failure–related hospitalizations and emergency department visits may outweigh the additional drug cost in Medicaid members adherent to sacubitril/valsartan.

This study attempts to identify the sources of the significant 2.5-fold variation found in home health expenditures, a possible indicator of inefficiency and waste.

Advocacy and awareness; prevention and risk reduction; diagnosis, treatment, and care; caregiver support; and research were listed as actionable steps that are urgently needed to address global disparities in Parkinson disease.

Social determinants of health present many health-related challenges for Medicare Advantage (MA) plan members, something these plans are looking to overcome by diversifying their service offerings.

Abstracts presented at this year's American Society of Clinical Oncology Annual meeting detailed the financial hardships many patients with cancer face, including those related to high-deductible health plans and clinical trial participation.

At AHIP 2022, Vanessa Bobb, MD, PhD, FAPA, vice president of Behavioral Health & Medical Integration at CDPHP, moderated a session on real-world study findings showcasing cost and quality benefits of value-based contracting in behavioral health. Bobb discusses findings of the study and how value-based programs can be better leveraged in mental health and substance abuse care.

Integrating primary care with behavioral health services, improving provider training on mental health, and policy changes were all noted as strategies to combat the rising mental health and substance abuse epidemic during a keynote session at AHIP 2022.

Advanced practitioners (APs) have a role to play in strategies for integrating biosimilars into clinical practice.

Panelists of a keynote session at AHIP 2022 discuss how lessons learned from investment and infrastructure in public health during the COVID-19 pandemic can be leveraged to promote equitable care for all Americans and prepare for the next public health emergency.

A recent study found that pulmonary rehabilitation after hospitalization for chronic obstructive pulmonary disease (COPD) resulted in a net cost savings.

The utility of value-based frameworks for payers, providers, and those involved in kidney care delivery was addressed during a session at AHIP 2022.

On this episode of Managed Care Cast, we speak with Georges C. Benjamin, MD, executive director of the American Public Health Association, on the core takeaways of his keynote session at AHIP 2022 on public health policy and other solutions to promote equitable health and well-being.

Two stakeholders involved in investment and development of behavioral care services discuss the potential of digital therapeutics as a cost-effective alternative to address unmet mental health needs during an AHIP 2022 session.

Research found fecal microbiota transplantation (FMT) to be an optimal cost-effective treatment strategy for first and subsequent recurrent Clostridioides difficile infection (CDI), challenging current guidelines.

Panelists of an AHIP 2022 session discussed how future policy, infrastructure, and investment strategies in public health will reinforce the efforts already made during the pandemic, with partnerships and engagement key to optimize innovation.

Abstracts presented at the American Society of Clinical Oncology Annual Meeting evaluated biosimilar use in practices participating in the Oncology Care Model (OCM) and estimated the savings as a result of substituting these agents for more expensive reference products.

Community engagement, investment, and quality metrics were spotlighted as potential solutions to address health inequities affecting marginalized communities nationwide.

The FDA plans to set a maximum nicotine level in cigarettes and tobacco products to reduce addictiveness; a bipartisan bill would place a $35 monthly cap on insulin for patients with private insurance or Medicare; the Supreme Court ruled that an Ohio hospital’s employee health plan did not violate federal law by limiting coverage for outpatient dialysis.