Short answer: maybe. Attempts in the past have failed and a lot will need to happen this time to make it work. What consumers have for comparing physicians and hospitals is woefully inadequate, for the most part. The good news: Some health plans have the best tools around.
The internationally known health care economist is bullish on health care. For one thing, the system isn’t as bad as, say, education or jurisprudence. For another, costs have been slowing down for some time now. Administrative overhead needs to be tackled, though.
They want options, and they’re realizing that these entities are a much different breed from the public exchanges being rolled out under the Affordable Care Act. Meanwhile, consumer advocates worry that private exchanges will shift too much burden onto patients.
Clopidogrel, Prasugrel, or Ticagrelor? Which of the three is the best oral antiplatelet medication? Clopidogrel is the least expensive, and that’s important for pharmacy directors at health plans. Effectiveness also counts, however, and there are significant clinical differences. Studies aren’t much help.
Utilization management for outpatients cuts testing rates significantly, according to a review of claims for over 2 million patients. Use declined the most in low- and medium-risk groups. Food for thought for clinician executives as the authors note that there have been few cost-effectiveness studies on this.
John Sung Kim
There have been no novel medications for decades, and exisiting therapies don’t have enough of an impact on morbidity and mortality rates
Aetna hopes that an experiment with its employees turns into a product that it can put on the market next year
Physicians will be able to order the correct therapy in as little as two hours after taking a sample for testing