Patients are more likely to fill prescriptions that treat costly, chronic diseases when health insurers offer them a financial incentive to do so through value-based insurance design. That's the good news in a research review just published by the journal Health Affairs.
The bad news? Research has yet to show any significant drop in overall medical spending, wrote authors of the review, which examined prior studies of value-based design and proper medication use.
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First Aetna, and now UnitedHealth.
United, the nation's largest health insurer based on enrollment, followed in the footsteps of Aetna's move last month and decided to exit California's individual market. That includes leaving the state's individual health insurance exchange after saying it would participate, the Los Angeles Times reported Tuesday.
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Dr. Peter Bach, an oncologist at Memorial Sloan-Kettering Cancer Center in New York, is calling for a radical revamp of Medicare's cancer drug payment program. "The current financing method for physician-administered oncology drugs is unsustainable," he writes in an online Viewpoint on the Journal of the American Medical Association website.
Oncology practices currently operate by charging a mark-up on the retail sales price of chemotherapy drugs. Previously set at 6%, the federal budget sequester dropped that to 4.2%, and the CMS is talking about further lowering it to 3% to hold down costs as the price of the latest cancer drugs soars. The average sales price system provides oncologists with bigger margins if they choose the most expensive drugs, which they are under increasing pressure to do because of the cuts. Responding to oncologists' protests, at least 91 sponsors in the U.S. House of Representatives have signed onto legislation restoring the 6% mark-up.
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Sebelius
When Sen. Max Baucus (D-Mont.), chairman of the powerful Senate Finance Committee, told HHS Secretary Kathleen Sebelius that he worried Obamacare's implementation was headed for a “train wreck,” she publicly promised to bring him into the loop.
Turns out that Sebelius kept her word and has been giving Baucus one-on-one briefings on the law's implementation every other week since his very public April 17 complaint about a lack of information.
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