- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Additional Reimbursement Considerations in Oncology
During this discussion, Scott Gottlieb, MD; Michael Kolodziej, MD; and Ted Okon, MBA, further discuss how various reimbursement models are impacting clinical practice in oncology.
Dr Gottlieb begins by explaining why the CMS stepped in to regulate the practice of medicine by implementing additional rules regarding the provision of oncology products.
Healthcare reform has impacted oncology care in the United States in many ways, including the establishment of oncology medical homes and the implementation of payment reform models, remarks Mr Okon. He also describes differences in drug pricing in the community setting versus the hospital setting, and discusses the so-called drug incentive.
When establishing measures to help improve current healthcare models, various stakeholders should collaborate and discuss opportunities for achieving optimal efficiency, suggests Mr Okon. Stakeholders also need to work together to improve the reimbursement model for oncology services.
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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Facilitators of and Barriers to Medicaid Investment in Electronic Consultation Services
March 5th 2025In this qualitative investigation, leaders of Medicaid managed care plans were interviewed to identify facilitators of and barriers to electronic consultation for specialty care delivery.
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Higher UTI Risk After Spinal Fusion in Patients With Certain Comorbidities
March 5th 2025A study investigated the incidence of postoperative urinary tract infections (UTIs) in patients undergoing spinal fusion for deformities, finding that patients with more than 12 levels fused had the highest UTI rates.
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