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A New Attempt Emerges To Bridge GOP Divisions On AHCA (Updated)
April 21 Update: New Aid For State Formulary Review At REGTAP On April 17, 2017, CMS announced that it would be turning the job of drug formulary review for qualified health plans over to state regulators in the thirteen HealthCare.gov states that have plan management responsibility.  On April 19, CMS offered at its REGTAP.info website (registration required) a seminar on the qualified health plan (QHP) application review tools for prescription drugs that the states may use for these reviews. The EHB Category and Class Drug Count Tool, which is new for the 2018 QHP review period, reviews drug lists to ensure that QHPs com...
Source: Health Affairs Blog - April 20, 2017 Category: Health Management Authors: Timothy Jost Tags: Costs and Spending Featured Following the ACA Insurance and Coverage Source Type: blogs

Price, Sessions Force Trump ' s Hand on Cost-Sharing Reduction Payments
In a recent op-ed atThe Federalist, I argued Donald Trump has serious leverage over both Republicans and Democrats in Congress when it comes to ObamaCare:President Trump can force Republicans and Democrats back to the negotiating table, and get a bill that keeps his promises to  fully repeal Obamacare and to protect people with preexisting conditions…by simply undoing the illegal actions by his predecessor, which he has also already promised to do.One of those illegal actions is theillegal exemption from ObamaCare that President Barack Obama granted members of Congress and their staffs.Another is the illegal “cost-s...
Source: Cato-at-liberty - April 20, 2017 Category: American Health Authors: Michael F. Cannon Source Type: blogs

Too Long, you don ' t have to read . . .
. . . because I ' ll tell you, as a follow-up to my previous post.David Gorski has good things to say, as he does here, but if brevity is the soul of wit Dr. Gorski is not at all witty. (I think he already knows that but he can ' t help himself.)Anyway, so-called " Right to Try " legislation has passed in 33 states, and an effort is underway to pass a federal version. This is one of those policy ideas that looks great on a bumper sticker and is impossible to refute in 30 words or less. Since the voting public gets turned off by wonkery, politicians who know better duck and cover when these proposals come along, so they pas...
Source: Stayin' Alive - April 18, 2017 Category: American Health Source Type: blogs

Yes, Mr. President. Health Care is Complicated. And Also Hard.
By ASEEM SHUKLA, MD “Nobody knew that health care could be so complicated,” President Donald Trump told us a few weeks ago.  As the failure of the House Republican  bill shows: Healthcare is hard. The American Healthcare Act failed to clear the House of Representatives despite catering to longstanding conservative demands: rid the ‘individual mandate’ (designed to force able-bodied people to pay insurance so it’s cheaper for sick people), subsidies to individuals, and revamping Medicaid into block grants to states. Even with the claim it could be deficit-neutral, the act failed to win enough moderat...
Source: The Health Care Blog - April 14, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Where is the patient in the discussion of the opioid epidemic?
The opioid epidemic has been declared loud and clear in the media over the past several years.  Doctors have been demonized, and patients have been stereotyped.  The statistics are alarming.  However, I have yet to see anything published that focuses on the patient who lives with chronic pain.  There is very little understanding for these individuals. Let me be more specific.   Society reacts empathetically towards the person who has pain related to cancer or a severe medical condition, such as a burn.  But what about the patient with less tangible pain?  We assume that these individuals are drug seekers that haven...
Source: Kevin, M.D. - Medical Weblog - April 13, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/s-blake-kelly" rel="tag" > S. Blake Kelly, MD < /a > Tags: Physician Pain management Source Type: blogs

10 Things Every Alzheimer's Caregiver Needs to Know and Discuss with Their Doctor
TheAmerican Geriatrics Society has published a list of ten things doctors and their patients should consider, know and understand.I think it is important forevery caregiver of a person living with Alzheimer's, or a related dementia, todiscuss these 10 issues with the doctor. Doing this in advance might be one of the most important caregiverdecisions you can make.It might also be a good idea toshare this article in support groups, and bookmark (save) it so you can find it when you need it.What is Alzheimer's Disease?By Carole Larkinhttp://www.alzheimersreadingroom.comI think this is an important list of things that nee...
Source: Alzheimer's Reading Room, The - April 13, 2017 Category: Neurology Authors: rtdemarco at gmail.com Tags: alzheimer care care of dementia patients dementia help for caregivers elderly dementia care geriatrics health help alzheimer's help with dementia help with dementia care life news memory care facility Source Type: blogs

I Was Thinking
I ' m sorry, I know I shouldn ' t spend time thinking because it can cause all sorts of problems. I know. I should stop spending so much time thinking. I ' ll think about that for a while.Anyway, I was thinking because I read an article on the giantRheumatoid Arthritis Time Suck. When you have RA you spend a lot of time going to the doctor to deal with doctors for RA and then all the time dealing with the side effects of your RA medications. And your low immune system which makes you high risk for everything. And blood tests every 8 weeks. And more and more.But then I get to add in the fibromyalgia time suck which causes t...
Source: Caroline's Breast Cancer Blog - April 13, 2017 Category: Cancer & Oncology Tags: ailments thinking time Source Type: blogs

Value Frameworks For Rare Diseases: Should They Be Different?
The US health care system is increasingly focusing on value as a basis for reimbursement of pharmacotherapies and devices, and as a result the use of “value frameworks” for measuring and comparing treatment value has grown in recent years. However, the therapies assessed by most frameworks frequently apply to modest-to-large disease populations, rather than the smaller populations affected by rare diseases, where the factors driving value may differ. Rare diseases are different from diseases affecting larger populations in several fundamental ways. In the United States, a rare disease is defined as one that affects few...
Source: Health Affairs Blog - April 12, 2017 Category: Health Management Authors: Anupam Jena and Darius Lakdawalla Tags: Costs and Spending Drugs and Medical Innovation Quality Orphan Drug Act Precision Medicine rare disease treatment treatment value value frameworks Source Type: blogs

A Strategy For Lowering Brand Drug Prices: Patent Buyouts And Licensing
Why does competition among brand drugs often fail to reduce prices? In this post, I address that question, which is obviously important in structuring efforts to reduce prescription drug costs. Based on the answer, I then propose a mechanism to increase competition among brand drugs and lower prices. Specifically, I advocate the creation of nonprofit entities to purchase the intellectual property rights to any one of several competing brand drugs and license those rights to multiple generic manufacturers. Understanding Prescription Drug Competition In model systems, the profit-maximizing price for a competing monopolist de...
Source: Health Affairs Blog - April 5, 2017 Category: Health Management Authors: Jonathan Silver Tags: Costs and Spending Drugs and Medical Innovation Drugs and Medical Technology drug manufacturers innovation incentives intellectual property prescription drug prices Source Type: blogs

What Now?: A Four Step Plan For Bipartisan Health Reform
As I concluded in my Health Affairs Blog post last Monday, it should be clearer now than ever that new steps to improve our health care system must be pursued on a bipartisan basis. In the past week, several Members of Congress and the President himself have expressed interest in finding consensus solutions to the challenges we face. Democrats, meanwhile, have responded in kind. While it will not be easy, we ought to applaud these gestures and, as health care stakeholders, demonstrate our preparedness to support efforts to improve health care access and reduce costs. With that in mind, I have compiled here a range of sensi...
Source: Health Affairs Blog - April 4, 2017 Category: Health Management Authors: Billy Wynne Tags: Featured Following the ACA Insurance and Coverage Medicaid and CHIP Quality bipartisanship Congress house v. price MACRA section 1333 Source Type: blogs

Some Things are Better Left Unsaid
It’s been on the news, but thankfully not too much. The US Preventive Health Services Task Force just issued a statement saying there was “no evidence of value for celiac disease screening.” Taken out of context, without a careful reading of the statement, an understanding of the distinction between “screening,” “diagnosis,” and “case finding,” without sufficient background about the role of the Task Force, and in the midst of today’s controversies about “going gluten free,” this statement might easily lead to misinterpretation by patients, families, clinicians and insurers. Even with my years of ex...
Source: Disruptive Women in Health Care - April 3, 2017 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Uncategorized Source Type: blogs

Fight Aging! Newsletter, April 3rd 2017
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - April 2, 2017 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

Health Care: What Should a Populist Do Now?
Conclusion The most common response to the suggestion that private contracts could be useful in reforming the health-care system for the benefit of ordinary Americans is the observation that people—ordinary Americans in particular—cannot reasonably be expected to read, let alone understand and compare, the multiple contracts they would confront. This point, however, while valid, is beside the real one, which is to give adequately subsidized consumers meaningful choices with respect to the cost and content of their future health care and enough reliable help in making them that they can be reasonably content with their ...
Source: The Health Care Blog - April 1, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Repealed and Misplaced
By KIP SULLIVAN Like Joe, Michael and others, I find myself wondering what, if anything, Trump learned from the demise of the AHCA last Friday. But I’m also wondering what Democrats and other Republicans are thinking. The question I would like to ask all Republicans is: Is it clear to you now that merely saying no to any Democratic proposal to lower the uninsured rate is bad for your party? The question I would like to ask all Democrats who supported the Affordable Care Act is: Is it clear to you now that that the managed care nostrums in the ACA cannot lower costs, and that attempting to lower the uninsured rate wi...
Source: The Health Care Blog - March 26, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized AHCA Freedom Caucus Trump William Kristol Source Type: blogs

Reaching Beyond Delivery System Walls To Improve Colorectal Cancer Screening
Conclusion Screening rates are a product of two factors: offer rates and uptake/completion rates. With our FIT campaign we have made strides in both areas. With tools built into our EHR, we can now identify and offer tests to nearly 100 percent of the eligible population, practically with the touch of a button. At the same time, patient uptake of testing has improved dramatically, despite the fact that FIT screening must be done every year, instead of the five- and ten-year intervals required for sigmoidoscopy and colonoscopy, respectively. We believe the increased uptake is a testament to what happens when we “make the ...
Source: Health Affairs Blog - March 24, 2017 Category: Health Management Authors: Theodore Levin, Joanne Schottinger and Murray Ross Tags: Featured Health Policy Lab Innovations in Care Delivery Organization and Delivery Population Health capitated payment model Colorectal Cancer Screening electronic health record fecal immunochemical test Healthcare Effectiveness Data and Source Type: blogs