Kaiser Health News discusses how the Affordable Care Act's preventive services mandate can be confusing to plan members. The fact of the matter is that it's confusing for everyone because the nature of the mandate which relies on expert medical panels like the U.S. Preventive Services Task Force, requires HHS to interpret the medical expert's positions, and HHS tends to take an expansive view of the required coverage. And it remains controversial whether or not all of these preventive services actually save health care dollars from a macro-standpoint as this Reuters article explains.
A 2010 study in the journal Health Affairs, for instance, calculated that if 90 percent of the U.S. population used proven preventive services, more than do now, it would save only 0.2 percent of healthcare spending.But it's the law.
Some disease-prevention programs do produce net savings. Childhood immunizations, and probably some adult immunizations (such as for pneumonia and the flu), are cost-saving, found a 2009 analysis for the Robert Wood Johnson Foundation. The vaccines are cheap, and large swaths of the population are vulnerable to the diseases they prevent. The cost of providing them to everyone is less than that of treating the illnesses they prevent.
Counseling adults about using baby aspirin to prevent cardiovascular disease also produces net savings. The counseling is inexpensive, the aspirin even cheaper and the costs of heart disease, which strikes one in three U.S. adults, are enormous. Screening pregnant women for HIV produces net savings, too.
Those, however, are exceptions.
The Drug Channels Institute is preparing to release its 2013-14 Economic Report on Retail, Mail, and Specialty Pharmacies. Here are some highlights:
- The top five dispensing pharmacies—CVS Caremark, Walgreens, Express Scripts, Rite Aid, and Walmart—accounted for about 65% of U.S. prescription dispensing revenues in 2013.
- Market share concentration in 2013 was slightly greater than that of 2012.
- We project total 2013 retail, mail, and specialty pharmacy revenues of $287.0 billion, up 1.6% from 2012.
AIS Health reports on how United Healthcare has brought its prescription management business in house from Medco / Express Scripts to OptumRx.