Adherence to medications is essential for patients with chronic disease for optimizing clinical outcomes. When used appropriately, medication is a very cost-effective method for treatment and prevention of disease. Patients who fail to take their medications as prescribed do not get the full benefit from the drugs, and they may also end up with unnecessary hospitalizations, emergency department visits, and nursing home admissions. Cost-effective, scalable interventions are essential to reduce nonadherence.

Efficient Automated Call System Improves Adherence, but What about Net Costs?

In 2006, the Centers for Medicare & Medicaid Services' (CMS) ruling went into effect, mandating that all Medicare Part D prescription benefit sponsors must offer their members a medication therapy management (MTM) program.1 Among other requirements, CMS mandates Part D sponsors to have an MTM program to reduce the risk of adverse events and ensure optimum therapeutic outcomes for targeted beneficiaries through improved medication use.1 CMS gives basic guidelines of requirements for eligibility into the program.

Allergic rhinitis (AR) is one of the most common chronic conditions in the United States, affecting approximately 40 million people.1 Although AR is rarely considered a severe medical condition, its bothersome symptoms, such as sneezing, rhinorrhea, and congestion, can negatively affect important domains of quality of life, including sleep, social interaction, and work.2-7 In a recent large national survey of adults with AR, 78% of those surveyed indicated that nasal congestion was a moderately or extremely bothersome symptom of AR.5 Other nasal symptoms oft

Relieving Nasal Symptoms: Uncommon Excellence in a Common Clinical Condition

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
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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
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  • Inside Patient Care: Pharmacy & Clinic
  • Lynx CME