November 21st 2024
Despite significant progress in expanding health insurance coverage since the Affordable Care Act (ACA) was enacted, millions of Americans still face critical gaps in access and affordability to health care.
November 20th 2024
State Policy Opportunities to Control Health Care Prices: A CPR Report
September 25th 2024Catalyst for Payment Reform (CPR) explores stakeholder perspectives in Florida, Michigan, and Nevada, revealing both the challenges and opportunities states face in reforming health care pricing structures.
Read More
New FTC Lawsuit Against PBMs Has Broad Implications for Pharmaceuticals, Ted Okon Says
September 24th 2024Ted Okon, MBA, executive director of the Community Oncology Alliance, spoke with The American Journal of Managed Care® about how the Federal Trade Commission's (FTC) lawsuit against pharmacy benefit managers (PBMs) could affect the future of pharmaceuticals and oncology.
Read More
Extended Time in ED Linked to Reported Racial Discrimination and Patient Dissatisfaction
September 24th 2024Boarding times in the emergency department (ED) have risen nationally, but the implications for health equity have remained understudied. This study investigated whether prolonged ED boarding contributed to perceived racial discrimination and dissatisfaction with care.
Read More
Medicare High-Value Drug List Model Could Lower Out-of-Pocket Costs for 4 in 10 Beneficiaries
September 23rd 2024The 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.
Read More
CMMI's Latest Payment Models Address Health Disparities, but Challenges Remain
September 22nd 2024"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.
Read More
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.
Read More
US Health Care System Ranks Last Overall Among Other High-Income Countries
September 19th 2024The 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.
Read More
It’s Time to Address Our Nation’s Health Care Price Crisis
September 18th 2024This 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.
Read More
Biden-Harris Administration Expands Mental Health Coverage Protections Nationwide
September 10th 2024Ali 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.
Read More
UPMC's Dr Manisha Jhamb Urges Better Kidney Disease Awareness, Integrated Care
September 4th 2024Manisha 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.
Watch
CMS Negotiated Drug Prices: Cardiologist's View on Affordability, Future Innovation
September 3rd 2024Ty 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.
Watch
Beyond Average Spending: Distributional and Seasonal Commercial Insurance Trends, 2012-2021
September 3rd 2024Analysis 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.
Read More
Cost in Cardiovascular Care: ESC 2024
September 2nd 2024A 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.
Read More
Tackling Obesity for Heart Health: A Global Weight Crisis
September 1st 2024The 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.
Read More