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What We're Reading: New Company Helps Fight Medical Bills
What we're reading, September 28, 2016: a new company will help people fight their medical bills; prescription drug monitoring programs may not be helping the opioid crisis; and why banning pay-for-delay deals may not help to lower costs.
A new start-up company is helping people fight their medical bills by connecting their insurance to a platform for constant scrutiny of every claim. According to The Atlantic, the service doesn’t come cheap, with Remedy taking 20% of the savings. There is currently a $99 cap in place for a single bill, but that could change. Remedy’s business is built around the fact that statistics show medical errors are responsible for $120 to $150 billion in overcharges each year.
Prescription drug monitoring programs may not be helping the opioid crisis, after all. These state-run databases are supposed to turn up evidence of abuse, but may make things worse as addicts start looking to street drugs for their fix, reported Politico. The programs have helped identify patients who doctor shop or doctors who overprescribe painkillers, but new data show that in many of the states using a drug monitoring database, heroin overdoses are skyrocketing.
One of Hillary Clinton’s proposals to lower drug costs is to ban “pay-for-delay” deals. However, this strategy may not be very effective, according to an opinion piece in STAT. Through pay-for-delay deals, drug companies with a branded drug offer to pay a generic company to stay out of the market for a set number of years. Unfortunately, these settlements are difficult to uncover, which means a more nuanced approach to reining in drug prices is necessary.
Urticaria Diagnosis Challenged by Overlapping Pruritic Skin Conditions
April 23rd 2025Urticaria is complicated to diagnose by its symptomatic overlap with other skin conditions and the frequent misclassification in literature of distinct pathologies like vasculitic urticaria and bullous pemphigus.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz
April 23rd 2025Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
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