Like the everyday person, defining value for a payor of healthcare services varies depending on your perspective and application of the meaning. For a patient or employee, value means there is some worth in the usefulness of the subject or importance to possessing it. To a clinician, value relates to a standard of quality or a principle that is not only worthwhile, but also desirable. For an attorney, value is defined in contractual terms connoting an economic exchange or equivalence in goods or services.

Value-Based Drug Benefit: Implications for Manufacturers

The data regarding healthcare costs are clear, persistent, troubling at the least, and truly frightening at worst. It is estimated that by 2014, nearly 20% of the nation's economy will be consumed by healthcare, and the growth in healthcare spending will outpace economic growth through the next decade.1 The National Institutes of Health estimated that the overall cost of cancer in 2006 was $206.3 billion. Of this total figure, $78.5 billion represents direct medical costs, including inpatient and outpatient care, drugs, and devices.2

AHDB Stakeholder Perspective

The recent events surrounding the incidences of heparin contamination from China1 that was possibly willful in intent, as well as the dramatic increase in the estimated cases of deaths associated with heparin, point to a very troubling matter of terrorist elements in the medical product chain security.1 Vital records, financial accounts, and personal health records continue to be compromised at the nation's largest data warehouses.2-6 The massive loss of personal data and customers' transaction files that have been aligned for marketing purposes pose

Procedures Needed to Prevent Prescription Fraud

Employers around the country evaluate their company benefits package every year in the hopes of finding solutions to the ever-rising costs of health insurance premiums. For many business executives, however, the only logical choice is to pass along those increased costs to the employee.

The Lessons from Delaware's Employee Benefits Program

The cost of employee health coverage continues to grow faster than inflation,1 putting additional economic pressure on employers and raising critical questions about how best to provide health benefits while ensuring optimal employee health and productivity. As a result, employers have grown increasingly important in benefit design decisions—decisions that ultimately determine beneficiaries' access to medical products and services.

Cost-Shifting—Where Does It Stop?

Cardiovascular (CV) disease (CVD) is the primary cause of mortality among men and women in the United States. An estimated 80.7 million American adults (1 in 3) have 1 or more types of CVD; of these, about 47% are estimated to be 60 years or older.1 From an employer’s perspective, the economic burden of CVD has grown steadily over the past decade, fueled by rising medical costs coupled with the indirect costs associated with CV morbidity and mortality.

Employer-Based Wellness Initiatives: Lifestyle Modifications Insufficient in Employees at High Risk for Cardiovascular Disease

For employers, the underlying premise of benefit design is to provide quality healthcare services to their employees. Although the cost of providing healthcare benefits is a key consideration, employers balance this consideration against employee satisfaction and retention as well as productivity.1 The concept of a value-based benefit design (VBBD) has emerged over the past decade as a strategy to meet this objective.

Improved Clinical Outcomes the True Value of Copay Reductions for Diabetic Employees, Despite Increased Overall Costs

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
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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