For all the sturm und drang, experts foresee neither a hurry-up nor a halt for 2018, just a fairly steady continued rise at roughly last year’s higher-than-inflation pace. The Drug Price Forecast, for example (based on hospital and nonacute settings, but not retail pharmacy), reports that that means a tidy year-over-year increase of 7.61%.
A MedPage Today blog post suggests that they do. Industry veterans say they’re unaware of bonuses for denials but agree prior auth processes should be more transparent.
That’s thanks to about 57 million unplanned sick days for workers. The prevalence of diabetes in the adult population grew from 10.6% in 2008 to 11.6% in 2016. It was at 11.5% for the first nine months of 2017.
Ezekiel J. Emanuel’s Prescription for the Future is true to its title and proposes a five- to 10-year agenda for transforming expensive, wasteful American health care into a system that delivers high-value care. This is a qualitative book based on case studies that identify and systematize how to improve quality, patient experience, and cost.
Value-based care can’t be done one slice at a time, new value-based models will take aim at variations in care, the patient may gain a stronger voice, the tail could wag the dog, and value-based care will create haves and have-nots. Some predictability from the federal government would be welcome.
The document “Feature and Function Recommendations To Optimize Clinician Usability of Direct Interoperability To Enhance Patient Care” offers recommendations from the clinician point of view. Widespread adoption of even a few of these recommendations by designers and vendors would greatly enhance care.
Training primary care physicians to identify and treat oral health problems will go a long way toward integrating care for those problems with general medical care, according to a study in the Journal of the American Board of Family Medicine.
Morality rates for inpatient hospitalizations for opioid abuse quadrupled between 2000 and 2014, according to a study in Health Affairs. The mortality rates increased from 0.43% before 2000 to 2.02% in 2014. In 2016, 15,000 Americans died from heroin overdoses and 20,000 others died from overdoses from synthetic opioids.
As expected, pharmacy costs increased with the introduction of this new treatment in a market dominated by over-the-counter and generic treatments. On the other hand, outpatient GI-related and irritable bowel disease health care resource use and costs substantially decreased among commercial and Medicare patients following linaclotide treatment initiation.
Anthem’s vice president of provider alignment solutions wants providers to know that the spigot of upside-only risk arrangements will not stay open forever.
The rate of developmental disabilities for children ages 3 to 17 in the United States rose from 5.76% in 2014 to 6.99% in 2016, according to the CDC. The prevalence of children who had been diagnosed with a developmental delay other than autism spectrum disorder or intellectual disability also increased from 3.57% to 4.55%.
Elisabeth Rosenthal has a unique perspective on what ails the American health care system. She is a physician turned journalist who has some firsthand knowledge about what takes place in American hospitals and doctor’s offices, although her Wikipedia entry makes a point of describing her as a “non-practicing physician.”
Hemlibra demonstrates how far antibody science has progressed. Genentech’s drug, approved late last year, connects two clotting factors to prevent the devastating bleeds in hemophilia patients with inhibitors. The high price may be offset by avoided costs in patients with factor VIII inhibitors.