Policy

One of the most talked about subjects at the SCAI 2013 meeting was the Appropriate Use Criteria (AUC). There are great economic and potential implications associated with the designations of appropriate or inappropriate for specific diagnostic procedures and treatments.

Predictive modeling can be used to identify disabled Medicaid beneficiaries at high risk of future hospitalizations who could benefit from appropriate interventions.

Integrated health systems are often portrayed as the most effective in providing high-quality care at lower costs. This systematic review assesses the empirical evidence.

Manesh Patel, MD, an interventional cardiologist at Duke University began by presenting a talk entitled, Appropriate Use Criteria: The Reasons, Methods, Intended, and Unintended Consequences. He first pointed out that Medicare expenditures on imaging have doubled between 2000 and 2006.

As payment reform models continue to evolve, practitioners must determine which strategy makes the most sense for their practice. Although the idea behind bundled payments may be worth considering, there are some concerns that this system could causes disruptions in oncology practices.

Patrick Gleason, PharmD, Director of Health Outcomes, Prime Therapeutics, says benefit design trends in specialty pharmacy show that the preferred specialty tier is generally a cost share of around one hundred dollars for a 30-day supply.