Insurance

Entering the Medicare Part D coverage gap does not result in a large reduction in medication adherence for essential drugs.

Hospitals in more competitive markets had significantly lower costs per discharge for both Medicare and privately insured patients.

The former nurse and hospital company executive, Marilyn Tavenner, has been confirmed as administrator for the Centers for Medicare & Medicaid Services (CMS). Tavenner has been serving as the interim administrator for the CMS since 2010. Her appointment, which has officially been vacant since Dr Mark B. McClellan stepped down in October 2006, came after much debate as to whether or not she should officially lead the organization.

Even experienced providers say prescribing has become too complex and time consuming with Medicare Part D plans, which differ in formularies and prior authorization processes.

Predictive modeling can be used to identify disabled Medicaid beneficiaries at high risk of future hospitalizations who could benefit from appropriate interventions.

Manesh Patel, MD, an interventional cardiologist at Duke University began by presenting a talk entitled, Appropriate Use Criteria: The Reasons, Methods, Intended, and Unintended Consequences. He first pointed out that Medicare expenditures on imaging have doubled between 2000 and 2006.

The cost-saving potential of specialty or disease-specific ACOs can be huge...but it is unclear whether these specialty services are more efficiently provided through their own ACO or as ancillary to the burgeoning primary care ACO marketplace.