What options do payers have for setting prices for high-cost drugs? Examples include volume discounts, performance based contracts and coverage with evidence. However, is there a comprehensive taxonomy one can use for defining all these different pricing and payment options? The closest we have come is a new paper by Ardito, Ciani & Drummond (2024)….
A new KFF analysis finds that there were 44 million people enrolled in health coverage through the Affordable Care Act’s Marketplaces and its expansion of the Medicaid program in 2024. That represents about 1 in every 6 people under age 65, or 16.4%. There was significant variation in ACA enrollment across states, ranging from…More
In 2024, ACA enrollment (including Marketplace, Medicaid expansion, and BHP) reached 44 million, or 16.4% of the nonelderly U.S. population. From 2020-2024, enrollment in ACA coverage increased by over 60%.
The good news is that virtual solutions are becoming more sophisticated every day to eliminate these care deserts. These promising strategies are helping. The post Tech-driven Heart Care Key to Cardiology Desert Crisis appeared first on MedCity News.
AI/big data haven’t solved healthcare’s challenges. Despite advancements, systemic barriers persist, but AI offers potential to improve outcomes and efficiency. The post Is ‘Big Data’ the Cure-all for U.S. Healthcare? appeared first on MedCity News.
Combining AI-driven insights with tailored care pathways, patients gain access to health coaches, psychologists, and treatment plans, while providers benefit from workflow optimization. The post GVX Venture Studio Launches FusionCare.AI: A One-Stop Shop for Obesity Care at the Future and Health Executive Summit at JPM 2025 appeared first on MedCity News.
Prior authorizations continue to challenge healthcare organizations as payer authorization requirements expand and change. Automated prior authorizations can bring new efficiency and consistency to a process that’s ripe for evolution, but how will providers make the leap? Alicia Pickett, Senior Product Manager at Experian Health, shares her perspectives on the issues providers are talking about…
Jessie Mazar squeezed the grab handle in her husband’s pickup and groaned as contractions struck her during the 90-minute drive from her home in rural northeastern California to the closest hospital with a maternity unit. She could have reached Plumas District Hospital, in Quincy, in just seven minutes. But it no longer delivers babies. Local…
It takes a lot of courage to grow old. I’ve come to appreciate this after conversations with hundreds of older adults over the past eight years for nearly 200 “Navigating Aging” columns. Time and again, people have described what it’s like to let go of certainties they once lived with and adjust to new circumstances….
Revenue for the blockbuster Eli Lilly drugs Mounjaro and Zepbound continues to grow, but not as much as expected. At the J.P. Morgan Healthcare Conference, Lilly CEO David Ricks explained why the company revised downward its projections for fourth quarter 2024 revenue. The post At JPM, Eli Lilly’s CEO Explains Why Mounjaro, Zepbound Sales Were…