Advances in the diagnosis and treatment of cancer in recent decades have dramatically improved the life expectancy, quality of life, and productivity of patients with cancer. Today, a growing number of employees remain in the workforce while they are being treated for cancer or return to work after their treatments are completed. Cancer is being seen as a chronic and manageable disease in the workforce, similar to diabetes or asthma.

Data-Driven Benefit Design for Chronic Diseases

Adherence to prescribed medications is necessary to improve outcomes.

Medication Adherence: Is Lower Copay the Best Strategy to Improve Care and Reduce Costs?

In the spring of 2008, the Zitter Group conducted a large national study of the insurer–employer relationship to understand how these 2 stakeholders interact in the creation of healthcare benefit design. The 2-arm study consisted of concurrent web-based quantitative surveys with commercial managed care executives, large employers, and major employer benefits consultants.1 It was designed to provide a richly detailed snapshot of trends in employer-sponsored healthcare coverage.

The Cost-Sharing Conundrum: Greater Stakeholder Collaboration Needed

Obesity is associated with many chronic diseases and is classified as a disease by several organizations, including the World Health Organization, the National Institutes of Health, the US Food and Drug Administration (FDA), and the Centers for Disease Control and Prevention (CDC).1-4

Payers' Incentives Are Not Aligned to Address the Obesity Epidemic

Local school districts are one of the largest employers in the United States, employing roughly 8 million employees in 2008.1 Locally, they are often one of the largest (if not the largest) employers in the communities they serve. Like many large employers, school districts offer an array of benefits to their employees, including health insurance. Employee benefits comprise 34.3% of total compensation for publicsector employees,2 with health insurance representing 10.9% of total compensation.2

Public Employer Characteristics

Health Insurance Premium Increases for Large Employers

As the number of patients with diabetes increases, there is growing concern about the adequacy of reimbursement levels for delivering comprehensive diabetes care.

Diabetes Management Strategies: More Money Does Not Equal Better Care

Chronic kidney disease (CKD) affects approximately 26 million people in the United States.1 Diabetes and hypertension cause up to two thirds of all new CKD cases.1,2 According to Medicare policy, health plans are financially responsible for the care of CKD patients for up to 33 months after they have reached the final stage of end-stage renal disease (ESRD).3 Data from the Institute for Health and Productivity Management 2001 database show that treatment costs nearly double from one stage of CKD to the next.4 The stages of CKD are defined based on

Alignment of Incentives along the Healthcare Payer Continuum for Patients with Kidney Disease

Hyperphosphatemia is prevalent among patients with end-stage renal disease (ESRD) and continues to be an important and challenging area for drug therapy.

Balancing Horizontal and Vertical Equity within Managed Health Plans Drug Benefit

Across socioeconomic strata, American households are adopting an increasingly electronic way of life. Bills are routinely paid online, bank balances are tracked, goods are purchased, and music is downloaded at record consumer adoption rates.1 Income levels, bank balances, and consumer preferences are routinely shared and stored in the electronic ether. There is a unity of confidence and comfort on behalf of the consumer and the vendor that these personal pieces of information are safe and secure.

Electronic PHRs and e-Prescribing: Not Quite There Yet

Pharmaceutical manufacturers face an increasing drug utilization dilemma—not related to formulary acceptance—in the US marketplace regarding patent expiration, new-entry pharmaceuticals, and biotechnology products. Influencers of health plan reimbursement program decision makers (eg, benefit managers, consultants, consumer advocates) and reimbursement transaction platforms need more attention from pharmaceutical marketers and senior executives in relation to their current and emerging product pipeline.

The Many Challenges of Pay-for-Performance Programs
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  •  Association for Value-Based Cancer Care
  • Value-Based Cancer Care
  • Value-Based Care in Rheumatology
  • Oncology Practice Management
  • Rheumatology Practice Management
  • Urology Practice Management
  • Inside Patient Care: Pharmacy & Clinic
  • Lynx CME