Yesterday, the Centers for Medicare and Medicaid Services announced a proposal to control drug costs in Medicare Part B. Medicare Part B covers doctor administered drugs which tend to be more expensive that the drugs that patients pick up at the local pharmacy or receive by mail and self administer. The Wall Street Journal reports that "the proposal is meeting stiff opposition from the pharmaceutical industry and some providers—especially cancer centers where many high-price specialty drugs are used—because of the proposed drop in reimbursement." This looks like another major cost shift from Medicare to the employer sponsored and exchange plans is brewing. In this regard, and to reinforce an ongoing FEHBlog leitmotif, take a look at this AHIP Coverage article, "It's not the cost of health care, it's the price" that's the problem. Also with regard to these Medicare intiatives, read this Health Data Management report from the HIMSS conference that health care providers are concerned about the pace of the shift to value based compensation.
Fierce Health Payer reports on an academic study published in Health Affairs cautioning insurers about the growing use of retail clinics typically based in pharmacies. But as a practical matter what are insurers expected to do as the cat is out of the bag.
Modern Healthcare informs us that Health Affairs includes another study which estimates the high cost of provider reporting of quality measures -- time that otherwise could be spent with patients.
Researchers at Weill Cornell Medical College in New York City teamed up with the Medical Group Management Association to put a price on the time providers spend to enter the data into the electronic health record, keep track of newly introduced measures and create protocols to track and report them.
The answer is about $15.4 billion a year, according to their study published Monday in the health policy journal Health Affairs.
That's “a large amount of money being wasted on checking this box and that box,” said lead study author Dr. Lawrence Casalino, chief of the division of health policy and economics at the Weill Cornell Medical College in New York City. “It's time physicians could spend on not rushing a patient, or thinking about a diagnosis more carefully.”
This study emphasize the importance of health plan implementation of the recent CMS-AHIP collaborative consensus on core quality measures.