Entries in Thayer, Claire (156)

Friday
Mar172017

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

GOP’s 3-Bucket Strategy To Repeal And Replace Health Law Is Springing Leaks

Kaiser Health News reports: Republicans in Washington working to overhaul the Affordable Care Act say their strategy consists of “three buckets.” But it appears that all three may be leaking.

 

Price dodges on Medicaid rollback, immunization

Politico reports: Confronted by Medicaid recipients during a televised town hall event on CNN, Health and Human Services Secretary Tom Price offered few details Wednesday when asked to explain the reasoning behind the GOP's plan to roll back the health care program.

 

GOP Health Bill Narrowly Clears House Budget Committee

Morning Consult reports: The House Budget Committee on Thursday narrowly advanced the Republican health care bill to repeal and replace significant parts of the Affordable Care Act, with three Republicans voting against the measure.

 

By The Numbers: Trump’s Choice For FDA Chief Is Versatile, Entrenched In Pharma

Kaiser Health News reports: President Donald Trump’s pick to lead the Food and Drug Administration has deep ties to the pharmaceutical industry as a consultant, investor and board member. Scott Gottlieb, 44, also has worn many hats in a career that included two previous stints at the FDA, practicing as a physician, and writer/editor roles at prestigious medical journals.

 

Deciphering CBO’s Estimates On The GOP Health Bill

Kaiser Health News reports: The Congressional Budget Office is out with its estimate of what effects the Republican health bill, “The American Health Care Act,” would have on the nation’s health care system and how much it would cost the federal government. The GOP plan is designed to partially repeal and replace the Affordable Care Act passed during the Obama administration.

 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members. 

Friday
Mar102017

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

To Save On Drug Costs, Insurer Wants To Steer You To ‘Preferred’ Pharmacies

Kaiser Health News reports: One of California’s largest insurers has proposed a change in the benefits of commercial plans next year that would require consumers to pay more for drugs at pharmacies outside an established network.

Kaiser Health News

Friday, March 10, 2017

 

What Hospitals Waste

ProPublica reports: Just outside Portland, Maine, there’s a 15,000-square-foot warehouse that’s packed with reasons the U.S. health care system costs so much: Shelves climb floor to ceiling, stacked with tubs overflowing with unopened packages of syringes, diabetes supplies and shiny surgical instruments that run hundreds of dollars apiece.

ProPublica

Thursday, March 9, 2017

 

Ryan brings out slideshow to sell GOP healthcare bill

The Hill reports: Jacket off and sleeves rolled up, Speaker Paul Ryan (R-Wis.) on Thursday ditched the podium and delivered a 25-minute TED Talk-like presentation on why the new GOP health bill represents the best, and perhaps only, chance to repeal ObamaCare.

The Hill

Thursday, March 9, 2017

 

Lawmakers take up Obamacare revision without an independent scorekeeper

The Washington Post reports: Two committees in the Republican-led House have begun drafting sweeping health legislation without the benefit of an objective estimate of its impact from the Congressional Budget Office (CBO) — a reckless move, critics say, considering that they are dealing with the well-being of tens of millions of Americans and an industry that accounts for close to one-fifth of the economy.

The Washington Post

Wednesday, March 8, 2017

 

Three Key Senators Ask GAO to Investigate Possible Abuses Of The Orphan Drug Act

Kaiser Health News reports: Building on weeks of mounting pressure to address high prescription drug prices, three influential U.S. senators have asked the government’s accountability arm to investigate potential abuses of the Orphan Drug Act.

Kaiser Health News

Tuesday, March 7, 2017

 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

 

Thursday
Mar092017

Inaccurate Provider Directories Have a Direct Impact on Patients

By Claire Thayer, March 8, 2017

Provider directories are important tool for consumer engagement with health plans and provider networks. And in many instances, the provider directory is the vehicle for the patients’ first impressions of providers and the network they represent.  The consequences of directory inaccuracies create barriers to care as well as impact patient satisfaction. And while state and regulatory agencies are imposing stiff fines for non-compliance, a new report from the California Department of Managed Care finds that most insurers still have a ways to go in this regard as many have directories that contained “data inaccuracies significant enough to render them unusable.”

A recent special edition of the MCOL Infographic, co-sponsored by LexisNexis Risk Solutions, highlights the impact of directory inaccuracies on patients:

 

 

 

MCOL’s weekly infoGraphoid is a benefit for MCOL Basic members and released each Wednesday as part of the MCOL Daily Factoid e-newsletter distribution service – find out more here.

Friday
Mar032017

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 

Trump’s nominee to run Medicare and Medicaid advances

The Associated Press reports: President Donald Trump’s nominee to run Medicare and Medicaid won committee approval Thursday, clearing her for a final floor vote in the Senate.

AP via The Washington Post, March 2, 2017

 

Faring Better Than Many ACA Insurers, Molina Backs Health Law ‘Tuneup’

Kaiser Health News reports: Some large health insurance companies have suffered losses under the Affordable Care Act, leading to a few high-profile exits from the online marketplaces. Humana is just the latest, announcing in January that it will stop offering health insurance on the ACA health exchanges at year’s end.

Kaiser Health News,  March 2, 2017

 

High-Risk Pools Another Sticking Point Among Republicans

Morning Consult reports: Sen. Rand Paul on Wednesday expressed opposition to House GOP leaders’ plan to cover people with pre-existing conditions, highlighting another division that Republicans must overcome to repeal the Affordable Care Act.

Morning Consult, March 1, 2017

 

Insurers pay twice as much as hospitals for hip and knee implants

Stat News reports: Imagine this: You go to buy a car, but you don’t know who makes it, how other customers feel it’s performing, or how its price compares to other cars in its class.

Stat New, February 28, 2017

 

Hospitals, Both Rural And Urban, Dread Losing Ground With Health Law Repeal

Kaiser Health News reports: More than a year ago, she lost her job at a nearby rural hospital after it closed and, as Republicans work to dismantle the Affordable Care Act, wonders whether she’ll soon be out of work again.

Kaiser Health News, February 28, 2017

 

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members. 

Thursday
Mar022017

How Health Plans Impact Revenue Performance and Improve Quality Outcomes

By Claire Thayer, March 2, 2017

The Healthcare Effectiveness Data and Information Set (HEDIS) measures developed by the National Committee for Quality Assurance (NCQA) are now used by over 90% of health plans to measure quality performance.  HEDIS consists of 81 measures across 5 domains of care and address a broad range of important health issues, including:     

  • ·         Asthma Medication Use
  • ·         Persistence of Beta-Blocker Treatment after a Heart Attack
  • ·         Controlling High Blood Pressure
  • ·         Comprehensive Diabetes Care
  • ·         Breast Cancer Screening
  • ·         Antidepressant Medication Management
  • ·         Childhood and Adolescent Immunization Status
  • ·         Childhood and Adult Weight/BMI Assessment

Many health plans report HEDIS data to employers or use their results to make improvements in their quality of care and service.  Each year, NCQA publishes The State of Health Care Quality Report to raise awareness on key quality issues and drive improvement in the delivery of evidence-based medicine. This report documents performance trends over time, tracks variation in care and recommends quality improvements.  Additionally, HEDIS data is also incorporated into many health plan ‘report cards’ and increasingly used by consumers and purchasers to track and compare health plan performance.

This week, a special edition of the MCOL Infographic, co-sponsored by DST Health Solutions, focused on strategic trends and key elements of performance improvement for health plans: 

 

 

 

MCOL’s weekly infoGraphoid is a benefit for MCOL Basic members and released each Wednesday as part of the MCOL Daily Factoid e-newsletter distribution service – find out more here.