Community Servings, a not-for-profit organization in the Boston area, delivers medically tailored meals that take into account the nutritional needs of people with chronic illnesses. The idea is to ensure that a patient'...Community Servings, a not-for-profit organization in the Boston area, delivers medically tailored meals that take into account the nutritional needs of people with chronic illnesses. The idea is to ensure that a patient's food addresses his or her specific health conditions.
Former inmates addicted to opioids too often land back in jail. A new program hopes to change that dynamic. It's based on the preached-more-than-practiced notion that people with opioid addiction need help, not punishmen...Former inmates addicted to opioids too often land back in jail. A new program hopes to change that dynamic. It's based on the preached-more-than-practiced notion that people with opioid addiction need help, not punishment. Vivitrol injections are given to participants every 28 days for a year to help them stay clean.
Emblem Health and the Coalition of Asian-American IPA, a large physician group, wants to break down the language barrier to better help Asian American patients. The idea is that traditional health plan home-visit program...Emblem Health and the Coalition of Asian-American IPA, a large physician group, wants to break down the language barrier to better help Asian American patients. The idea is that traditional health plan home-visit programs can too often turn out to be disruptive, rather than helpful.
David Levine, MD, of Boston's Brigham and Women's hospital, is spearheading a program in which hospital level care is delivered to patients' homes. It's a research project for now. Eligible candidates who decide to parti...David Levine, MD, of Boston's Brigham and Women's hospital, is spearheading a program in which hospital level care is delivered to patients' homes. It's a research project for now. Eligible candidates who decide to participate are randomly assigned either to an inpatient-care control group or to Levine's "Home Hospital."
At the Mercy Virtual Care Center more than 850 employees deliver care by way of telehealth services to hospitals that are both inside and outside the Mercy system. Intermountain Healthcare has taken a similar approach, w...At the Mercy Virtual Care Center more than 850 employees deliver care by way of telehealth services to hospitals that are both inside and outside the Mercy system. Intermountain Healthcare has taken a similar approach, with its telehealth operation providing care to patients in more than 20 hospitals.
Geisinger's Fresh Food Farmacy program furnishes people with food for a healthy breakfast and dinner five days a week. That comes to about 4,500 meals a week. The idea is that if you give patients with diabetes a healthi...Geisinger's Fresh Food Farmacy program furnishes people with food for a healthy breakfast and dinner five days a week. That comes to about 4,500 meals a week. The idea is that if you give patients with diabetes a healthier meal their outcomes will improve.
The Pacific Business Group on Health in developing a "waste-free formulary" that it hopes all purchasers could use. Such a formulary would be limited to drugs with proven clinical utility and among those, the low-cost al...The Pacific Business Group on Health in developing a "waste-free formulary" that it hopes all purchasers could use. Such a formulary would be limited to drugs with proven clinical utility and among those, the low-cost alternatives. It is using a number of algorithms to evaluate medications.
Homelessness is a well-known social determinant of health, but health status also correlates with housing instability, a broader term that encompasses everything from trouble paying rent to living in overcrowded conditio...Homelessness is a well-known social determinant of health, but health status also correlates with housing instability, a broader term that encompasses everything from trouble paying rent to living in overcrowded conditions and to moving frequently. UnitedHealthcare Community Plan-Arizona gives beneficiaries shelter with the hope that health care spending on them will go down.
Robin Caruso, the chief togetherness officer at CareMore, knows that acute loneliness results in poor outcomes, increasing the risk of someone's mortality by 45%. Her team engages in "organic" conversations with CareMore...Robin Caruso, the chief togetherness officer at CareMore, knows that acute loneliness results in poor outcomes, increasing the risk of someone's mortality by 45%. Her team engages in "organic" conversations with CareMore's elderly beneficiaries to make them more engaged in their care, more socially connected, and more likely to exercise.
Ladapo JA, Budoff MJ, Azarmina P
… +5 more, Sharp D, Baker A, Maniet B, Herman L, Monane M
Manag Care
· 2018 Jun · PMID 29989911
PURPOSE: The evaluation of obstructive coronary artery disease (CAD) is inefficient and costly. Previous studies of an age/sex/gene expression score (ASGES) in this diagnostic workup have shown a 96% negative predictive...PURPOSE: The evaluation of obstructive coronary artery disease (CAD) is inefficient and costly. Previous studies of an age/sex/gene expression score (ASGES) in this diagnostic workup have shown a 96% negative predictive value, as well as an 85% decreased likelihood of cardiac referral among low-score outpatients at 45 days. The objective was to explore the one-year cost implications of ASGES use among symptomatic outpatients. DESIGN: A prospective PRESET Registry (NCT01677156) enrolled stable, nonacute adult patients presenting with symptoms suggestive of obstructive CAD at 21 U.S. primary care practices. METHODOLOGY: Demographics, clinical factors, and ASGES (defined as low <=15 or elevated >15), as well as management plans post-ASGES, were collected. The economic endpoint analysis was based on the cost of cardiovascular-related tests, procedures, office visits, emergency room visits, and hospitalizations during one year after testing. RESULTS: The analysis included 566 patients, 51% of whom were women and the median age was 56. Forty-five percent had a low ASGES. The mean cost of cardiovascular care for patients in the year following ASGES was $1,647 for patients with a low ASGES versus $2,709 for those with an elevated score (39% reduction, P=.03 by Wilcoxon rank test). This relationship remained after multivariate analysis that adjusted for patient demographics and clinical covariates (P<.001). CONCLUSION: The ASGES helped identify patients with low current likelihood of obstructive CAD. These patients had lower costs of cardiovascular care during one year of follow-up. Early reductions in cardiac referrals at 45 days among these patients persisted at one year.
Trogarzo (ibalizumab-uiyk) is a CD4-directed post-attachment HIV-1 inhibitor, indicated for use with other antiretroviral inhibitors in adults with multidrug resistant HIV-1 infection who aren't responding to their antir...Trogarzo (ibalizumab-uiyk) is a CD4-directed post-attachment HIV-1 inhibitor, indicated for use with other antiretroviral inhibitors in adults with multidrug resistant HIV-1 infection who aren't responding to their antiretroviral regimen. It is considered an advance. But FDA approval was based on a study of only 40 people-and it had no control group.
Breaking up type 2 diabetes into subtypes has been something that clinicians and researchers have discussed and debated for years. Swedish researchers have proposed a new taxonomy to do just that. If it takes, the trick...Breaking up type 2 diabetes into subtypes has been something that clinicians and researchers have discussed and debated for years. Swedish researchers have proposed a new taxonomy to do just that. If it takes, the trick will be to come up with treatment plans that fit individual patients based on these more precise diagnostic categories.
The stakes are particularly high when interpretations differ on evidence for treating diabetes, a condition affecting 30 million Americans and costing $245 billion annually. New guidelines from the American College of Ph...The stakes are particularly high when interpretations differ on evidence for treating diabetes, a condition affecting 30 million Americans and costing $245 billion annually. New guidelines from the American College of Physicians recommend less stringent blood sugar targets for most people with diabetes. Other professional groups think that's a terrible idea.
Health care is increasingly becoming like other retail encounters-a transaction between buyers and sellers. Patients, providers, payers-everybody needs to adjust. With the right technology and the will to change, the pro...Health care is increasingly becoming like other retail encounters-a transaction between buyers and sellers. Patients, providers, payers-everybody needs to adjust. With the right technology and the will to change, the process of paying for health care can become as simple-and as painless-as getting a haircut.
The PBM industry is under fire these days for what critics call its lack of transparency and its knotty contract language, secretive pricing schemes, and an inscrutable assortment of rebates, discounts, side deals, and a...The PBM industry is under fire these days for what critics call its lack of transparency and its knotty contract language, secretive pricing schemes, and an inscrutable assortment of rebates, discounts, side deals, and administrative fees. Some see partnerships with insurers and retailers as a possible solution. Opponents see a risk of even higher drug prices.
A state senator who describes insulin prices as "outrageous" introduced a transparency bill that requires drugmakers to report pricing, costs, and rebates. Other states might make similar moves, and the pharmaceutical in...A state senator who describes insulin prices as "outrageous" introduced a transparency bill that requires drugmakers to report pricing, costs, and rebates. Other states might make similar moves, and the pharmaceutical industry is suddenly on edge, with PhRMA and BIO fighting the law in court.
Even the most effective drug is useless if its cost prevents people from using it. Today's high drug prices are pushing more patients into nonadherence. This can impair or shorten life, and that's toxic for a system that...Even the most effective drug is useless if its cost prevents people from using it. Today's high drug prices are pushing more patients into nonadherence. This can impair or shorten life, and that's toxic for a system that has trouble controlling costs as it is.
Employers and health insurers are asking consumers to put "more skin in the game" with high deductible health plans, but don't provide incentives for them to choose high-value care. A recent study in the American Journal...Employers and health insurers are asking consumers to put "more skin in the game" with high deductible health plans, but don't provide incentives for them to choose high-value care. A recent study in the American Journal of Managed Care found no change in spending on 26 commonly used, low-profile services.
State laws that make meaningful price information available-e.g., paid claims, not charges, or prices for episode level bundles, and make these prices broadly available to the public-are an important step in enhancing pr...State laws that make meaningful price information available-e.g., paid claims, not charges, or prices for episode level bundles, and make these prices broadly available to the public-are an important step in enhancing price transparency. But the jury is still out on whether these efforts will make people buy health care based on quality.
PURPOSE: Current asthma guidelines combine treatment, follow-up, and reevaluation to manage asthma control, reduce impairment, and decrease risk of morbidity in patients. Clinical use of biomarkers, such as fractional ex...PURPOSE: Current asthma guidelines combine treatment, follow-up, and reevaluation to manage asthma control, reduce impairment, and decrease risk of morbidity in patients. Clinical use of biomarkers, such as fractional exhaled nitric oxide (FeNO), along with standard management can provide clinicians with improved ability to recognize airway inflammation, optimize drug therapy, and potentially increase asthma control. Our objective is to examine the impact of FeNO monitoring on the cost effectiveness of asthma management compared with management without FeNO. Sensitivity analyses further examine the impact of FeNO monitoring on patients with varying levels of severity and exacerbations. DESIGN AND METHODS: A decision-tree analysis of estimated outcomes and costs associated with annual management of asthma was utilized to simulate asthma management and treatment cost scenarios, comparing estimated 12-month costs and outcomes using the following treatment alternatives: (1) current standard of care (SOC) or (2) FeNO utilized in conjunction with the current SOC. Costs were estimated from the perspective of the health care payer; cost effectiveness was estimated as cost per quality-adjusted life year (QALY). RESULTS: FeNO in conjunction with SOC guidelines has decreased expected per-patient annual expenditure ($2,228) and increased expected per-patient annual QALYs (0.844) compared with SOC alone ($2,637 and 0.767). FeNO monitoring with SOC resulted in decreased annual costs and increased annual QALYs compared with SOC alone, and this difference was consistent through all one-way sensitivity analyses. CONCLUSION: Our analysis revealed that FeNO monitoring to guide asthma management is cost effective and could result in increased QALYs and decreased health care costs associated with asthma management.