Payment Reform Models in Oncology Care & Management
Authored by Mary Seery Cancer Treatment Centers of America National Director of Business Markets With everything going on in the world of politics, policy and health care, I am certain that oncology payment reform is not on the top of your mind – but maybe it should be! Years ago when I began working for a large health care system focused on oncology, I would not have bet and I am a bettor , that payment reform would so quickly have reached the complex world of oncology – but it has ...
Mary Seery, National Director of Business Markets for Cancer Treatment Centers of America (CTCA)
8 Questions to Ask Your Health Plan About Employer Reporting
According to the Centers for Medicare and Medicaid Services CMS , The $2.9 trillion we spend annually on healthcare—a whopping $9,200 per person—isn’t necessarily buying us the best care or ensuring good health. 1 At least two decades of statistics suggest there is an inverse relationship between employer health costs and employee health status. After all, research from the Kaiser Family Foundation shows premiums for employer-sponsored health insurance increased 203 percent bet...
Heather Lavoie, Chief Strategy Officer, Geneia
Help Determine Important Measures for Leapfrog's New Hospital Survey!
I just left Washington, D.C. where The Leapfrog Group held their annual meeting and presented the Top Hospitals Awards. In Florida we were lucky to have 11 hospitals receive this recognition. During the meetings we discussed a new proposed measure for the Hospital Survey. To see all the proposed changes, click here . As you will see in Section 3, Structural Measure 1: Minimum Volume Standards for Safety , they are addressing the strong relationship between volume and outcomes for both an individ...
Carving Out Mail Order, Specialty and Rebates
A Monthly Blog Series - #5 of 5 So far, in my series Weathering the Rx Storm , I’ve reviewed how to improve your PBM contract , how to develop a strong formulary & effectively manage benefits design and how to engage employees in new models . If you haven’t been following my series, then I recommend reading the first four blogs for a well-rounded look at saving money on pharmacy benefits. Today, in the final blog of this series, I’ll focus on the advantages of carving out m...
Engaging Your Members in New Models
A Monthly Blog Series - #4 of 5 In this blog series, I’ve discussed ways to review and improve your PBM contract, as well as achieving the best financial value from your benefit design, formulary, and specialty Rx. The next step is to help your members make informed decisions on what medications they should use, where they purchase them, and what cost effective alternatives exist. Making the right choices, with guidance, can help lower out of pocket costs and improve employee adherence to ...