April/May 2009, Vol 2, No 3
This is shaping up to be a watershed year for public health reform. Pressures of cost, quality, and access that have been building up under the healthcare boiler are about to produce their own peculiar set of eruptions, and the American healthcare system will look far different once the ensuing systems changes have taken effect. As they come into play, it will be instructive to keep an eye on the prize: will these changes favor cost, quality, or access, or will they produce the desired balance between them?
The Medicare Part D Prescription Drug Program was enacted on December 8, 2003, as part of the Medicare Prescription Drug Improvement and Modernization Act of 2003 and was implemented on January 1, 2006. Because the program was the largest major enhancement of Medicare since its inception in 1965 and was controversial in its original design, Congress chose not to amend the legislation until last summer.
Part D under the Medicare Improvements for Patients and Providers Act of 2008
March was a busy month for makers of generics and biologics, with several bills being introduced in the 111th Congress proposing new legislations on generics and biosimilars. While these bills are making the rounds in committee reviews, responses from industry stakeholders run the gamut from bipartisan support to partisan rejection, with few surprises.
ProvenCare: Geisinger’s Model for Care Transformation through Innovative Clinical Initiatives and Value Creation
Robert Henry: Two recent articles on ProvenCare discussed Geisinger’s innovative approach to patient care.1,2 Could you provide a quick synopsis of ProvenCare, and consider whether this system could help transform US healthcare from a sickness-based to a wellness-based system?
The patient-centered medical home (PCMH) continues to attract increasing attention from many industry stakeholders.1 The PCMH model has the potential to enhance the US healthcare system by rejuvenating primary care in a way that improves clinical outcomes, lowers costs, promotes wellness, and increases patient and physician satisfaction.1
Thanks to biologics, cancer is becoming not only a more chronic disease but also a resoundingly expensive one. In this economic climate, the financial framework for cancer care is headed for change, but how? At a recent webinar sponsored by Oncology Business Review (www.oncbiz.com), opinion leaders discussed the challenges and the options for meeting them.
Increased Patient Cost-Sharing, Weak US Economy, and Poor Health Habits: Implications for Employers and Insurers
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
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