Mexican immigrants are getting a chance to obtain benefits thanks to a program by Blue Cross of California that allows aliens to apply for health insurance by using their identification cards. "We have a health care crisis because there's too many uninsured using the system," says Michael Chee, a Blue Cross spokesman. "We would rather have them insured and paying into the system than draining the system." California has long been dealing with the problem of the uninsured.... Medical errors that stem from illegible handwritten prescriptions would be drastically reduced by a nationwide e-mail prescription system, according to a report by a company called eHealth Initiative. It argues that such a system would save the nation about $29 billion annually.... It could have been a contender, but instead it's just another merger that didn't quite come off. WellChoice's bid for Oxford Health Plans collapsed April 22. If the merger had happened, it would have created one of the biggest MCOs in the Northeast. Experts speculate that WellChoice may itself become object of an acquisition attempt.... Though HMOs continue to see the highest year-to-year premium increases, the plans remain the best bargain of the major health insurance products offered, according to a new Towers Perrin survey. Of course, after five years of double-digit increases, no one is particularly eager to throw the word "bargain" about.
House Republicans come out with their ACA alternative. A continuous coverage surcharge replaces the individual mandate. But where’s the CBO score?
The biosimilar segment of the pharmaceutical industry is on fire. Some 700 biosimilars are at some stage of development, and more than 660 companies are involved in some way in the biosimilars land rush. Still, only a handful may get on the market in the next few years.
No one knows how much of an effect biosimilars will have on oncology expenditures. Pricing and market share are in a large, opaque “to be determined” cloud. But there’s certainly potential for a major impact that could lower oncology expenditures by millions, if not billions.
The future of biosimilars in this country is nothing if not uncertain. Most immediately, the U.S. Supreme Court is hearing a case that will determine the timing of the 180-day waiting period before a biosimilar can go on the market. But there are larger and longer-term issues at play as well.
While coupons help individual consumers, they are also having a major impact on the insurance industry and anyone responsible for paying health care bills. Insurers and pharmacy benefit managers complain that they foil formularies and other pricing strategies designed to steer consumers to less-expensive drugs.
The hard truth is that telehealth’s future—its size, its contours—will depend a lot on what payers will be willing to pay for. Currently, commercial plans cover only a limited number of services. In addition, research suggests that there may be quality and utilization problems.
Insurers should consider covering new drug-delivery devices that can improve outcomes while lowering disease-specific pharmacy and long-term overall health care costs. Managing these devices in the pharmacy benefit will consolidate volume-based purchasing and capitalize on PBM strategies for improving adherence.
Basaglar is coming on the scene during tumultuous times for insulin products. Manufacturers are under attack for price hikes. There are allegations of backroom rebate deals. And a class-action lawsuit has been brought on behalf of uninsured patients, charging insulin makers with setting artificially high prices.
Evaluating the quality of telemedicine care is about as easy as evaluating the quality of health care, period, and researchers are still ironing out the methodological kinks. That may be one reason research results are all over the place. This article involved reviewing nine such studies, and the findings are a mixed bag.
If millions of Americans lose Medicaid or private health insurance coverage because of the unACAing of American health care, telehealth may seem like a gimmicky sideshow rather than a good-faith effort to bring health care into the digital century.