Policy

Medicaid programs provide hepatitis C treatments to needy patients despite the high price, said Matt Salo, executive director of the National Association of Medicaid Directors. He is optimistic that having more manufacturers in the market will bring costs down and make treatment more accessible for all.

When transitioning towards value-based oncology, large employers should look to value-based models that have worked for other conditions, said Karen van Caulil, PhD, president and CEO of the Florida Health Care Coalition. These successful payment models include patient-centered medical homes, bundled payments, and accountable care organizations.

Employers face tough decisions about rising costs, high-quality care, coordination of benefits, and workplace accommodations when employees are diagnosed with cancer, but they will always want to support those employees as best they can, according to Marianne Fazen, PhD, president and CEO of the Texas Business Group on Health.

A home-based palliative care (HBPC) program tested within an accountable care organization (ACO) demonstrated substantial cost savings and reduced hospital admissions for patients near the end of life, according to a Journal of Palliative Medicine study.

Many institutions and researchers responded to the PAN Challenge call for papers last year, and even more are expected this year, said Daniel J. Klein, president and CEO of the Patient Access Network Foundation. He emphasized that this year’s Challenge is especially important because it can help reduce the financial hardships that many cancer patients often face.

The rate of inmates infected with the hepatitis C virus is estimated at 17.4% across the United States, and can reach as high as 40% in some states. However, many inmates in state prisons are not permitted to receive the the newest and most expensive treatments for the virus.

“Healthy Steps for Older Adults,” the Pennsylvania Department of Aging’s falls prevention program, resulted in savings of $718 to $840 per person.

Nineteen percent of bills for out-of-network visits were negotiated, and of these negotiated bills, individuals were successful in lowering their costs approximately half the time.

The cost of an intravenous drug used to treat lead poisoning has skyrocketed after a 2700% price increase by Valeant Pharmaceuticals. Experts worry that its high price and the lack of alternatives will place it out of reach for hospitals that need it. This is not the first time Valeant has been criticized for its price-raising practices.

The authors aimed to examine whether participation in Medicare managed care, compared with fee-for-service, has any effects on racial/ethnic disparities in diabetes care and healthcare expenditures among older adults.

Researchers at the University of Chicago have developed a clinically relevant patient-centered tool that can measure a patient’s risk for financial stress.

The PAN Challenge is seeking long-term sustainable strategies to expand affordable access to care, which will benefit seriously ill patients the most, according to Daniel J. Klein, president and CEO of the Patient Access Network (PAN) Foundation.

Hospital consolidation has resulted in fewer choices for physicians and higher costs for patients, insurers, and taxpayers, according to Paul B. Ginsburg, PhD, the Leonard D. Schaeffer Chair in Health Policy Studies at the Brookings Institution and a professor of health policy at the University of Southern California.

Digital health programs like telehealth have already made progress in fields like mental health by expanding access and lowering costs, but there are opportunities to achieve much more in the future, according to Susan Dentzer, president and CEO of The Network for Excellence in Health Innovation.

Compared with Japan, the United States has substantially less geographic variation in surgical outcomes, but it has higher variation in cost.

Outpatient surgeries in the United States account for roughly 7% of annual healthcare expenditures. To exploit substantial opportunities to improve the value of outpatient surgical care, the authors composed an evidence-based care delivery composite for national discussion and pilot testing.

Scott Breidbart, MD, MBA, chief clinical officer of EmblemHealth, explained that paying patients for adherence could be efficient when the payment initiatives are targeted towards members who have not shown to be adherent; however, he added that there are several limitations in paying for adherence, including the sustainability of the system and whether it will incentivize patients who are adherent to stop taking their medications.

In the August issue of Evidence-Based Oncology, The Samfund's Samantha Watson, MBA, and Michelle Landwehr, MPH, outline how young adult cancer survivors are disproportionately affected by treatment costs. This infographic breaks down the vicious cycle these patients get stuck in.

Although team-based care improved cardiovascular disease risk factors, it had a negative financial impact on a primary care practice.

The authors surveyed physicians regarding “Choosing Wisely” and hypothesized drivers of overuse, finding high reported prevalence of hypothesized drivers of overuse and widespread support for cost-consciousness.

Biosimilars in the United States may demonstrate higher discounts and cost reduction than current estimates.

This paper estimates the costs and benefits of over-the-counter (OTC) statins using data on statin use and cardiovascular risk, clinical studies of statin safety and efficacy, and an OTC statin use trial.

The authors examine real-world hepatitis C virus cure rates with direct-acting antivirals among patients coinfected with HIV.

Expanding private-payer coverage of hepatitis C treatment may yield significant long-term cost savings for private payers, reduced costs to Medicare, and increased social value.

Expanding screening for hepatitis C virus infection may generate substantial benefits for patients and society, but only when paired with expanded treatment policies.

This special issue presents important new peer-reviewed research, covering issues ranging from access and the out-of-pocket costs of a treatment course, to the real-world consequences-both economic and clinical-of failing to treat.

Member cost negatively affects initial medication adherence and manufacturer coupons can decrease member share by up to 98%.

In the treatment of hepatitis C virus, the gap between efficacy and real-world effectiveness narrows with improved tolerability and ease of use.

This study analyzes the current coverage designs for hepatitis C virus drugs by Medicare Part D plans.