Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Health Insurance' Category

Should employers provide health insurance to their workers?

On this Labor Day, I want to address a fundamental question in the U.S. health care system: should employers provide health insurance to their workers?  I won’t take a stand on the issue but I will just list some pros and cons.  Wherever you stand on the issue, I recommend you carefully consider the arguments […]

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What do patients think about price shopping?

Initiatives such as high-deductible health plans (HDHPs) aim to transfer risk form insurers to patients. The rationale behind this risk transfer is that when patients are in control of more funds, there will be less moral hazard and patients will use health care resources more efficiently. That is the theory, but does it bear out […]

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Off-label use of cancer drugs

When each drug is approved by the FDA, the drug is not approved to treat all patients.  Each drug receives an “indication” which basically represents the types of patients the drug can treat.  Giving the treatment to patients with said indication is known as “on label” prescribing. Drugs developed to treat one disease may sometimes […]

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How many people don’t have any health insurance options

Much of the news has claimed that the Affordable Care Act is a failure because individuals in many counties have few or even no health insurance options.  However, how many counties truly will have zero Obamacare exchange insurance options in 2018 ? The Kaiser Family Foundation reports that there are only 17 counties covering 9,595 […]

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Pandemic Bonds

The World Bank is trying to insure against one of the worst crises in the world: a pandemic.  The Economist reports that the World Bank: …has issued $425m in pandemic bonds to support its new Pandemic Emergency Financing Facility (PEF), which is intended to channel funding to countries facing a deadly disease.  The bonds cover […]

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Is VBID gaining a foothold?

The answer is maybe.  Value-based insurance design ties patient cost sharing to the notion of a treatment’s value.  Higher value treatments have lower cost sharing; lower value treatments have higher cost sharing.  The Incidental Economist writes: In his own practice, Dr. Fendrick feels as if standard insurance is working against him and his patients. “They are deeply […]

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Will Better Care deliver better care?

The Senate’s new health care bill, the Better Care Reconciliation Act of 2017, proposes a number of changes to the Affordable Care Act.  The Kaiser Family Foundation has a detailed breakdown of the bill and compares it with the Affordable Care Act that President Obama passed and the American Health Care Act that was proposed […]

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The Future of Oncology Treatment and Value Assessment

Value frameworks are all the rage of late.  But are payers really using them? According to my colleague Jeremy Schafer, the answer is yes.  From an article in Drug Topics: “Value assessment may become more important as the health-care market shifts to outcomes and value-based reimbursement models,” said Jeremy Schafer, PharmD, MBA, Senior Vice President […]

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Prior authorization and opioid abuse

An interesting article by Cochran et al. (2017) examines whether health plan prior authorization rules can help prevent opioid abuse.  The authors use Pennsylvania Medicaid data from 2010 to 2012.  The data included both fee-for-service and managed care enrollees. The authors measured opioid abuse based on diagnosis codes for opioid use disorder (304.0, 304.00, 304.01, […]

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Interpreting evidence on value

Value is the latest jargon to hit the health care sector.  One potential way value could manifest itself is through value-based insurance design (VBID).  Under VBID, patients would pay lower copayments for treatments that are highly effective and/or low cost would pay higher payments for treatments that have low effectiveness or high cost to the […]

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