Global drug pricing continues to ignite fresh controversies as health policy makers, government health programs, health insurers, and pharmaceutical companies meet in heated debate. Solutions for health around the world rely on stakeholders having a clear understanding of the structure and logic behind drug pricing, but the complexities of the...
The medical goal for children diagnosed with pediatric cancers is remission or cure, but consistency and speediness of health insurance coverage is critical to access to preferred treatment. The therapeutic intervention differs based on the cancer type, stage, tolerance of the child to radiation and pharmaceutical agents, and numerous...
Controlling statewide costs in prisons was the rationale for privatizing the correctional healthcare delivery system across the nation, but there have been consequences. The increased incarceration levels and shift from governmental to private criminal justice system medical care has resulted in an additional burden of care placed on hospitals...
The causes of autoimmune disorders such as lupus, diabetes (type 1), rheumatoid arthritis, and Sjogren’s syndrome have not been determined, but an abnormal immune response is the common feature. While symptoms are mild in some patients, these can be highly debilitating (and even life-threatening) in other individuals. Due to...
Healthcare is undergoing a revolution in the transformation of data into credible, actionable information for decision making at all levels, including financing, coverage, reimbursement, product development, diagnoses and treatment, clinical care delivery, and consumer choices. In a fascinating new interview, one of the world’s top experts on health informatics discusses...
While mountains of raw health care data continue to grow, the challenge of turning that data into usable, actionable information is largely being unmet. There are certainly tremendous new opportunities to use information to improve health care decisions at the purchaser, plan, provider, and patient levels and thereby improve...
Hospital readmissions are costly but largely preventable. Reducing inpatient readmissions are a top priority for Medicare, state Medicaid programs, and private health plans. The opportunities to lower costs and improve patient outcomes are considerable. Therefore, healthcare purchasers are realigning hospital payment methods to reward hospitals for fewer readmissions and...
To control rising health care costs and improve outcomes, health care purchasers - Medicare, state Medicaid programs, and large employers - and health plans are eager to entirely replace traditional, inefficient, volume-based fee-for-service (FFS) physician and hospital reimbursement with value-based payment models. Value-based payment comes in various flavors but...
In the U.S., we usually hear about health care in Europe as an example of what the American health system is not. Universal health coverage, state-run provider networks, and rationing are the two differences that come up most often. But the U.S. and Europe share many health care policy challenges:...
Price transparency - or making price information publicly available - is an idea that has gained steam recently as one more way to reduce health costs and improve quality. So far, that has taken the form of online tools to help private health plan enrollees choose providers. But states...
