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Managed Care

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https://www.readbyqxmd.com/read/28273042/bioadvance-patient-support-program-survey-positive-perception-of-intravenous-infusions-of-infliximab
#1
Jennifer Jones, Mark Borgaonkar, Jesse Siffledeen, Ryan O#x02019;Reilly, Dana Anger, Dorota Dajnowiec, Martin Williamson, Peter Dyrda
PURPOSE: To understand the perception of intravenous infusions in patients receiving infliximab (Remicade) within the BioAdvance patient support program (PSP). DESIGN: Intravenous infusion of infliximab occurs at approximately 200 clinics across Canada and is managed via the BioAdvance PSP. Patients were invited to complete a 28-question survey on demographics, disease/treatment characteristics, health rating, lifestyle, employment, and perception of intravenous infusions and the BioAdvance program...
February 2017: Managed Care
https://www.readbyqxmd.com/read/28271992/evaluating-quality-of-medical-tourism-for-heart-surgery-measures-that-matter
#2
Michael Schlosser, Felix Lee
There are some success stories. Lowe's pioneering flat-rate deal with the Cleveland Clinic for heart surgery has shown both cost savings and quality improvement. Other large employers, notably Walmart and PepsiCo, have followed suit, signing contracts with self-described, single-hospital "centers of excellence" for a handful of elective procedures.
February 2017: Managed Care
https://www.readbyqxmd.com/read/28271991/new-therapy-for-spinal-muscular-atrophy-offers-modest-bang-for-pharamaceutical-buck
#3
Thomas Morrow
Spinraza is a breakthrough, no doubt. It is a survival SMN-2-directed antisense oligonucleotide indicated for the treatment of SMA in pediatric and adult patients and is administered by injections into the spinal fluid (intrathecally). But it is another ultraexpensive drug, and the evidence so far points to a modest improvement in motor milestones.
February 2017: Managed Care
https://www.readbyqxmd.com/read/28271990/time-for-a-sexual-revolution-in-health-care-treatment
#4
Zachary Hafner
In an age of consumerism and heightened attention to the whole patient across a broader continuum of care, organizations that support the availability of a broad set of sexual health services to a diverse group of consumers will have a big competitive advantage, but they may face challenges balancing the costs.
February 2017: Managed Care
https://www.readbyqxmd.com/read/28271989/q-a-a-conversation-with-david-france-the-hiv-aid-plague-years-and-where-we-stand-now
#5
Peter Wehrwein
Journalist David France's How to Survive A Plague is a searing firsthand account of the early years of the HIV/AIDS epidemic in New York City. AIDS activists, most of them gay men, were fighting for their lives. Researchers, politicians, public health officials, and pharma were slow to respond-or resisted outright.
February 2017: Managed Care
https://www.readbyqxmd.com/read/28271988/contraceptive-coverage-in-doubt-under-the-trump-administration
#6
Jan Greene
Women's health advocates are concerned about health coverage guarantees that could disappear as Republicans in Congress and the White House go about dismantling Obamacare. These include everything from contraceptive coverage to breast cancer screenings to equity in the premiums women pay for insurance.
February 2017: Managed Care
https://www.readbyqxmd.com/read/28271987/far-from-over-stds-have-made-a-comeback
#7
Susan Ladika
Not too long ago, rates for sexually transmitted diseases (STDs) in the United States were at historic lows. Now they are at record highs, and many experts fear they will continue to climb because of meager funding of public health clinics and diminished sex education in schools.
February 2017: Managed Care
https://www.readbyqxmd.com/read/28271986/intense-case-management-is-strong-medicine-for-hiv
#8
Robert Calandra
New York State's Target Case Management (TCM) program was created in 1990 by to help people with mental health and substance abuse issues stay engaged in their care. It's been very successful for people with HIV as well. Can it be expanded for other chronic conditions?
February 2017: Managed Care
https://www.readbyqxmd.com/read/28271985/for-ed-the-doctor-is-in-but-the-men-are-staying-away
#9
Joseph Burns
Men's health care changed dramatically after the FDA approved Pfizer's blue, diamond-shaped Viagra. Suddenly men were interested in seeing their doctors if for only one reason. Now, with restrictions on what some call a lifestyle drug, other health problems go uncharted.
February 2017: Managed Care
https://www.readbyqxmd.com/read/28271984/need-for-desire-drugs-debated
#10
Jan Greene
Some see a big market for medications for low libido in women. But sales of Addyi have been slow. Has a normal experience been unnecessarily medicalized? One of many factors in the debate is whether women#x02019;s sexual response tends to be more spontaneous or responsive.
February 2017: Managed Care
https://www.readbyqxmd.com/read/28271983/texas-a-test-for-defunding-of-planned-parenthood
#11
Richard Mark Kirkner
Texas is the petri dish of sorts for the anti-Planned Parenthood movement. Efforts to restrict Planned Parenthood funding there date back to 2011, when the legislature directed the state's Medicaid waiver program, the Women's Health Program, to exclude Planned Parenthood affiliates from its funding.
February 2017: Managed Care
https://www.readbyqxmd.com/read/28121599/health-information-technology-dos-and-don-ts-for-today-and-tomorrow
#12
Jaan Sidorov, Akash Randhar
The challenges include not overburdening physicians and fitting into an increasingly complex, multilayered informatics ecosystem. Innovative health care entities that neglect health care's reliance on evidence-based medicine and go to market without the benefit of any peer review do so at their own peril.
January 2017: Managed Care
https://www.readbyqxmd.com/read/28121598/is-step-therapy-a-move-in-the-wrong-direction
#13
Joseph Burns
If insurers insist that doctors use older, lower-cost drugs first, the burden is on the health plan to respond to doctors' request for different medications quickly, nimbly, and appropriately. But quick and nimble do not often describe insurers' step-therapy efforts.
January 2017: Managed Care
https://www.readbyqxmd.com/read/28121597/zinplava-tackles-toxins-of-hard-to-treat-c-difficile
#14
Thomas Morrow
Merck has recently received FDA approval for bezlotoxumab (Zinplava), as a treatment to reduce recurrence of C. diffcile in patients 18 years of age or older who are receiving antibiotic treatment for the infection and for whom there is a high risk of recurrence.
January 2017: Managed Care
https://www.readbyqxmd.com/read/28121596/real-world-evidence-and-the-unsticking-of-health-care-data
#15
Ramita Tandon
Ideally, real-world evidence would be continually looped back into the drug development process. There is a deep reservoir of information about side effects, adherence, and differences in efficacy among subpopulations embedded in the various sources of real-world evidence. Extracting it will take hard work.
January 2017: Managed Care
https://www.readbyqxmd.com/read/28121595/integrated-plans-fertile-for-real-world-evidence
#16
Frank Diamond
But most insurers are taking a wait-and-see attitude even though in some clinical areas, such as diabetes, real-world evidence (RWE) has been a true game-changer. Payers have a pessimistic view that RWE can help them. It doesn't help that respected voices in health care agree.
January 2017: Managed Care
https://www.readbyqxmd.com/read/28121594/observational-studies-fill-a-void-left-by-rcts
#17
Thomas Reinke
There is momentum building to use observational studies to investigate the safety and efficacy of medications in new ways. Drug companies are using them to establish the value of medicines in negotiating prices, rebates, and formulary placement with payers.
January 2017: Managed Care
https://www.readbyqxmd.com/read/28121593/variant-post-acute-care-needs-measuring-to-be-managed
#18
Carter Paine
Areas of the country with high concentrations of long-term acute care hospitals or inpatient rehabilitation facilities often have much higher utilization rates, even if a skilled nursing facility or home health provider could provide care comparable in quality and at a much lower price.
January 2017: Managed Care
https://www.readbyqxmd.com/read/28121592/accurate-encounter-data-a-must-for-medicaid-mco-quality-measurement
#19
Jason Duhon
CMS depends on encounter data submitted by state Medicaid programs to maintain the massive Medicaid Statistical Information System (MSIS), a database of claims, encounter data, and beneficiary eligibility information. Poor encounter data can hinder quality measurement in multiple ways.
January 2017: Managed Care
https://www.readbyqxmd.com/read/28121591/use-measures-metrics-to-tell-your-story-before-someone-else-tells-it-for-you
#20
Zachary Hafner
For both providers and payers, the time, effort, and resources dedicated to collecting and reporting data is exorbitant. While most reporting requirements are well intentioned, the proliferation is not adding value and-in some circumstances-does more harm than good.
January 2017: Managed Care
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