Health Care Cost

Carrie Kozlowski, OT, MBA, chief operating officer and cofounder of Upfront Healthcare, explains how the company emphasizes personalized engagement to overcome technological, cultural, and social barriers while Medicaid disenrollment rates are increasing.

Coverage from "Navigating the PBM Landscape: How a Heath Care Economist Sees It," at Patient-Centered Oncology Care 2023.

"I'll say what I don't think the issue is—it's not technology. We can solve this problem with technology," Carrie Kozlowski, OT, MBA, explains in the interview.

Over the past 20 years, Medicare physician pay has plummeted by 26% when adjusted for inflation, while hospital reimbursement has surged by 70%, prompting over 100,000 doctors to abandon independent practice for hospital or corporate employment since 2019.

Overcoming insurance hurdles for critical medications; rising heat and wildfires reverse decades of clean air progress; conflicts between parents and schools arise as teens seek mental health support

This study leverages newly available hospital pricing data to explore hospital-insurer contracts from a large hospital chain.

Patients enrolled in a preventive drug list (PDL) benefit saw an 8.4% reduction in acute, preventable diabetes complication days, and PDL members residing in lower-income areas saw a 10.2% decrease compared with control members.

A provision in the Inflation Reduction Act will implement a $2000 out-of-pocket cap on Medicare beneficiaries’ prescription drug spending, which could save money for more than 1 million enrollees when it takes effect next year.

House Republicans voted to ban quality-adjusted life years (QALYs) from being used as a drug pricing metric in federal health programs; insurance executives disapproved of newly proposed 2025 Medicare Advantage (MA) rates; patients with long COVID enrolled in an online exercise program said their health improved more than people who received standard care.

Clinical investigators evaluated the impact of home health services on disability status and receipt of treatment among adults 66 years and older with a new diagnosis of multiple myeloma (MM).

Amazon and Health Warehouse’s direct-to-consumer pharmacies had the most expensive and commonly used generic drugs available in 2020, whereas Walmart only had a small fraction.

States channel billions into housing for the homeless using Medicaid funds; AstraZeneca invests $300 million to discover and develop cell therapies; the CDC highlights dangers of menthol cigarette addiction.

Using an instrumental variable approach, this study is the first to present causal estimates of the effect of preventive dental visits on overall medical expenditures.

The Center on Health Equity and Access provides real-time updates, shares cutting-edge research, and supports continuous efforts dedicated to tackling health care disparities and enhancing widespread access to high-quality health services.

Pandemic-era policies that made it easier for patients to receive opioid addiction treatment will continue permanently; the Biden administration is facing pressure from Democrats and reproductive health groups to make sure the first OTC birth control pill is affordable; a FDA expert panel on Friday is set to resume the debate over how to make pulse oximeters more accurate for people with darker skin.

The newly appointed president and CEO of the National Alliance of Healthcare Purchaser Coalitions discussed timely issues where we may see progress in 2024.

Days spent obtaining health care outside the home may show access to needed care, but also add up to substantial time, effort, and cost burdens to patients and those who care for them, according to the study authors.

CMS released the proposed 2025 Advance Notice for the Medicare Advantage (MA) and Medicare Part D Prescription Drug Programs; there have been 561 deaths related to the use of Philips’ recalled ventilators and machines for treating obstructive sleep apnea since 2021; the FDA warned the public against copycat eye drops due to infection risk.

Medicare-eligible patients with cutaneous squamous cell carcinoma (cSCC) could save on health care costs by utilizing the 40-gene expression profile (40-GEP) to guide treatment decisions.

This analysis compared outcomes among patients who have Duchenne muscular dystrophy (DMD) and commercial insurance or Medicaid, focusing on how these differ between patients in clinical trials and those who receive treatment post approval.

Aducanumab’s accelerated approval was controversial and insurance coverage of the expensive therapy was limited.

Drug prices in the US increased 4.4% annually and median out-of-pocket (OOP) costs increased 9.6% annually from 2009 to 2018, but there was no direct link between these amounts for individual drugs.

Sickle cell disease (SCD) will be the first focus of the Cell and Gene Therapy (CGT) Access Model; the FTC has challenged the validity of over 100 drug product patents to help increase competition and potentially lower prices; the rate of infectious syphilis cases in the US rose 9% in 2022.

Attention-deficit/hyperactivity disorder (ADHD) medication packets are found with incorrect pills; CMS data reveal record numbers of providers and beneficiaries participating in accountable care organizations (ACOs); Supreme Court will hear arguments over FDA regulations on abortion medication in March.

UPMC Health Plan member Marjorie Robinson, of Monroeville, Pennsylvania, tells of her experiences with Pittsburgh-based Fabric Health as a single mom of 2 teenagers and why she believes that mental health–related concerns can be significant obstacles to overall good health.

Biden administration launches partnership with Instacart; critics raise concerns over pharmaceutical industry influence in negotiations; patients seek alternatives as Novo Nordisk halts insulin production.

Serena Sloane, a Pittsburgh-based certified nursing assistant, took advantage of a chance meeting at her laundromat with someone from Fabric Health to learn more about her options for bettering her health care benefits

The Center on Health Equity and Access delivers current updates, highlights breakthroughs in research, and ongoing endeavors committed to addressing healthcare inequalities and improving universal access to exceptional health care.

US women in low-income regions are experiencing a steep increase in cervical cancer diagnosis and death despite medical improvements; a Senate committee launches an assisted living examination, its first hearing on the industry in 2 decades; the CDC urges health care providers to be alert for patients who have fever, rashes, an traveled abroad following reports of 23 measles cases since December 1.

The data suggest this burden among patients who have myasthenia gravis (MG) is prevalent across insurance types.