Copay Assistance Is Meant To Defray Patient Drug Costs. Some Insurers Keep It Instead.
For 16 years, Larry Gruber, a fitness coach from Wilton Manors, Florida, received a coupon…
Copay Assistance Is Meant To Defray Patient Drug Costs. Some Insurers Keep It Instead.
For 16 years, Larry Gruber, a fitness coach from Wilton Manors, Florida, received a coupon card to help him pay for a psoriatic arthritis medication he needs that costs more than $7,700 a month. Each year, Amgen, which makes the drug, called Enbrel, sent the coupon card worth thousands of dollars, and that counted toward…
Thousands of Medicare Beneficiaries Thought Their Drug Plan Was Free. Then They Lost It.
Jude Pare and his partner, Diane Tix, live in rural Minnesota until temperatures dip below freezing, when they take refuge in Arizona for the winter. While away, their mail is forwarded. But Pare, 77, said he didn’t receive any warning from his Medicare prescription drug plan that his $0 monthly premium was about to increase….
AI: Rewiring the Machine
In a conversation focused on the technology underlying AI in health care, Chip is joined by Seema Verma, former administrator of the Centers for Medicare & Medicaid Services (CMS), and now Executive Vice President and General Manager at Oracle Health and Life Sciences, the second largest electronic health records (EHR) platform in the U.S. Seema shares her insights on the evolution of EHRs and why it’s necessary to redesign these systems to better…
Life Not As We Know It
By KIM BELLARD Well, let’s see. Last week much of the U.S. and parts of Europe were under a crippling heat dome. The U.S. celebrated its 250th birthday. And there’s something called the World Cup going on, for those of you who care about such things. But, I mean, really, the news of the week?…
Report Highlights Private Equity’s Lesser-Known Strategy: Nonprofit Joint Ventures
A new report finds private equity firms are increasingly using joint ventures with nonprofit health systems to expand in healthcare, prompting calls for greater oversight. The post Report Highlights Private Equity’s Lesser-Known Strategy: Nonprofit Joint Ventures appeared first on MedCity News.
Why Penn Medicine Is Deploying AI Agents for Patient Intake
Penn Medicine is integrating K Health’s AI-powered patient intake agents into its virtual primary care service. The health system says the goal is to free up time for patient care rather than information-gathering. The post Why Penn Medicine Is Deploying AI Agents for Patient Intake appeared first on MedCity News.
On the importance of innovation and entrepreneurship
“I will maintain that there is no comparably important question in economics, because this is the question of human progress. This is the question of human wellbeing over millennia. Everything else about resource allocation, about policy, about macro…everything else is a footnote to this larger question of how new things come into being and how…
A $1B Acquisition Gives Novartis a Way to Stand Out in Crowded Area of Cancer
Myricx Bio brings to Novartis antibody drug conjugates with a novel cancer-killing payload called an NMT inhibitor. Novartis says Myricx’s drugs could have advantages over currently available ADCs as well as those still in clinical development. The post A $1B Acquisition Gives Novartis a Way to Stand Out in Crowded Area of Cancer appeared first…
Medicare Advantage Insurers Deny Prior Authorization Requests for Post Acute Care at Substantially Higher Rates Than the Overall Denial Rate
Two recent reports find that Medicare Advantage organizations deny prior authorization requests for long-term care hospital, inpatient rehabilitation hospital, and skilled nursing facility stays at higher rates than requests overall. When these decisions are appealed, they are frequently overturned, particularly for skilled nursing facility stays. This may cause delays for Medicare beneficiaries who are particularly…
In Oncology, the Cost Problem Goes Beyond Predictability
Healthcare does not lack the data needed to better understand oncology costs. What it does lack is a consistent way to connect clinical progression with financial impact in a time frame that aligns with strategic planning. The post In Oncology, the Cost Problem Goes Beyond Predictability appeared first on MedCity News.
