Susan Dentzer: It is time to move past denying the perfect storm facing U.S. healthcare
The healthcare sector is facing a perfect storm of aging patients, rising costs, aging providers, and a shortage of primary care physicians, creating a need to a shift toward preventive care, increased use of technology, more virtual and home care and sustainable care teams.
FTC takes legal action against pharmacy benefit managers, citing a distorted drug-pricing structure
A growing dispute between pharmacy benefit managers (PBMs) and government regulators intensified Sept. 20 when the Federal Trade Commission (FTC) filed suit against the three leading PBMs and their affiliated group purchasing organizations (GPOs). The complaint against CVS Caremark, Express Scripts, Inc. (ESI, owned by Cigna) and OptumRx (UnitedHealth Group) seeks to address a system…
David Johnson: 10 forces are combining to disrupt healthcare’s status quo
The U.S. healthcare system operates in much the same way it has for the past 100 years: always hospital-centric, physician-centric, disease-centric, treatment-centric and transaction-centric. Providers receive payment for the specific treatments they deliver. There is limited care coordination, little emphasis on prevention, inadequate provision of mental health services and woeful chronic disease management. The result…
Improving diversity in clinical drug trials
Erika is joined by Quintin Maidment, a vice president at CTRx Pathways, to discuss why diversity is critical in clinical drug trials and what barriers stand in the way.
ONC issues proposed technical standards to improve health information sharing
Proposed regulations bring healthcare providers and patients a step closer to gaining access to key health information stored in payer databases. Provisions in a proposed rule published Aug. 5 by the Office of the National Coordinator for Health Information Technology (ONC) support a CMS final rule released in 2020 and another issued early this year,…
How to re-engage hospitalists, rebuild care teams and improve LOS in the post-COVID environment
Healthcare teams are facing disrupted communication pathways and relationships due to the COVID-19 pandemic, leading to increased length of stay (LOS) and financial performance issues, but a back-to-basics approach with hospitalists leading care team rebuilding can help overcome these challenges.
Ken Perez: An assessment of the health policies of Kamala Harris and Donald Trump
The 2024 presidential election features a shift in policy position by Democratic Party candidate Kamala Harris, who has distanced herself from her previous advocacy of Medicare for All, while Republican Party candidate Donald Trump appears less intent on repealing the Affordable Care Act.
Hospitals will get only a small bump in Medicare inpatient payments for FY25
Hospital representatives were less than excited about the rate update in Medicare’s FY25 final rule for inpatient care and long-term care hospitals. Published Aug. 1, the rule includes a 2.9% rate increase for acute care hospitals in the fiscal year that begins Oct. 1. The increase is derived from a 3.4% hike in the market…
As providers seek resolution of continuing Change Healthcare issues, UnitedHealth Group reports strong financials
The aftermath of the Change Healthcare cyberattack affected the second-quarter financials of parent company UnitedHealth Group (UHG), but not to the point of hindering the company’s continued “diversified and durable growth,” CEO Andrew Witty said during a recent investor call. Q2 revenues increased by 6% year-over-year, while profits dropped by 5.5% amid costs stemming from…
FTC report levies strong criticism at the business practices of pharmacy benefit managers
Vertical integration by pharmacy benefit managers (PBMs), including with providers, is one reason to be concerned about the excessive reach of PBMs in the healthcare industry, according to an interim staff report issued this month by the Federal Trade Commission (FTC). “Due to decades of mergers and acquisitions, the three largest PBMs now manage nearly…