The questions: Should CMS increase pay to PCPs for services that they currently provide but are not compensated for, and pay for new services that CMS would like PCPs to perform? Or should CMS pay for demonstration projects that target high-need, high-cost Medicare beneficiaries? CMS’s answer, at least for the time being, is a bit of both.
Women are a key focus segment for health care organizations both because of the medical services they utilize as individuals and the influence they have on the health care of others. In one survey, 59% of women and 94% of working moms reported making or heavily influencing health care decisions for their entire families.
Women who were new patients waited an average of nearly 24 days to be seen by an ob/gyn, according to research by Athenahealth. In contrast, the new-patient wait to see for an orthopedist was 13 days. Waits for first appointments with primary care physicians, pediatricians, and cardiologists fell in between those two extremes.
For Americans younger than 65, the share of people with private health insurance in a high-deductible plan increased from 39.4% in 2016 to 42.9% in 2017.
The overall infant mortality rate in the U.S. declined 14% between 2005 and 2015, from 6.86 infant deaths per 1,000 live births in 2005 to 5.90 in 2015, according to the CDC. However, CDC researchers found wide variation among the states, ranging from 9.08 deaths per 1,000 live births in Mississippi (the highest rate), to 4.28 deaths per 1,000 live births in Massachusetts (the lowest).
It’s a must because there is a cost to keeping the underserved that way whether that means funding integrated primary care to help people live healthier lives or footing the bill when people get care in the emergency department.
CMS is granting waivers that impose work and other new requirements on some Medicaid beneficiaries. Medicaid managed care plans are wary of the added administrative complexity—and possibly a change in the Medicaid population’s risk profile.
The winners among the Part D preferred pharmacy networks are willing to trade lower prescription profit margins for larger market share. CVS pharmacies are preferred in plans that enrolled 8.5 million people in 2018, compared with the fewer than 300,000 people enrolled in CVS retail pharmacies in 2017.
In Slow Medicine, Victoria Sweet, MD, pulls the reader into a different reality, one that harkens back to an earlier era of one-on-one medicine, when physicians and patients commonly shared a bond of trust and familiarity. That era has faded with the emergence of systems of care and performance targets.
Baby boomers and millennials are the hardest hit by the heroin and opioid epidemic. Boomers, born between 1946 and 1964, top the list, having 27% greater chance of dying from prescription opioids than people born in 1977 and 1979, the baseline group. They also have a 33% chance of dying from a heroin overdose.
The drugs often are more effective and have fewer side effects. The science—often just amazing. Medically, cancer treatment has never been in a better place. But are high prices making it unaffordable? Payers, providers, policymakers, and drugmakers themselves are wrestling with the issue. Meanwhile, many patients are being priced out of treatments that could save their lives.
Cut an inch-long incision into someone’s scalp. Then drill a hole into the skull that’s no bigger than a dime. Insert an electrode directly into the brain that targets the reward center, the nucleus accumbens. Then thread a wire beneath the skin to a pacemaker implanted in the patient’s chest. That’s deep brain stimulation.