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The Evolution of Buy-and-Bill
Following a brief discussion of the shortcomings of the buy-and-bill model in oncology, Michael Kolodziej, MD, and Brian Kiss, MD, describe the origins of the model and suggest changes needed based on the evolution of healthcare reimbursement strategies in the United States.
Dr Kolodziej defends the buy-and-bill model, explaining that it originated in the 1980s as a way for practices to help pay for the infrastructure needed for cancer care to be delivered in the community setting rather than in the hospital setting.
Because treatment options in oncology have evolved and oral oncolytics that can be dispensed via practice-based pharmacies are now available, adds Dr Kiss, the latest challenge is determining how to compensate oncologists fairly given the introduction of oral drugs.
Resolving these issues will require agreement and collaboration among multiple stakeholders in healthcare, Dr Kolodziej remarks.
Higher Life’s Essential 8 Scores Associated With Reduced COPD Risk
November 21st 2024Higher Life’s Essential 8 (LE8) scores, especially those reflecting lower nicotine exposure and better sleep health, are inversely associated with chronic obstructive pulmonary disease (COPD) risk, emphasizing the importance of cardiovascular health (CVH) in disease prevention.
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Study Highlights Key RA-ILD Risk Factors, Urges Early Screening
November 20th 2024This recent study highlights key risk factors for rheumatoid arthritis–associated interstitial lung disease (RA-ILD), emphasizing the importance of early screening to improve diagnosis and patient outcomes.
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Exploring Racial, Ethnic Disparities in Cancer Care Prior Authorization Decisions
October 24th 2024On this episode of Managed Care Cast, we're talking with the author of a study published in the October 2024 issue of The American Journal of Managed Care® that explored prior authorization decisions in cancer care by race and ethnicity for commercially insured patients.
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Why Right Heart Catheterization Confirming PAH Diagnosis May Be Underperformed
November 20th 2024Professional guidelines say that when pulmonary arterial hypertension (PAH) is diagnosed, right heart catheterization should be performed, but a quarter of the time, it isn’t—so investigators set out to discover why.
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