One of the largest and most important parts of our health care system is the role employers play in providing health insurance coverage for workers, retirees, and family members. U.S. employers cover 55.1% of Americans who have health insurance, according to a report released by the U.S. Census Bureau.
By providing health insurance for more than half of all Americans, employers pay for the biggest share of health coverage in the United States. Continue reading
A recent study from the Commonwealth Fund and the Pacific Business Group on Health (PBGH) shows that developing a waste-free formulary by cutting the number of high-cost, low-value drugs in employers’ health benefit plans could save employers as much as 24% in pharmacy spending.
Concern about rising prescription drug costs has caused large self-insured employers to develop innovative formularies for the pharmacy benefit plans they provide to employees, their family members and retirees. A formulary is a list of drugs that employers and health plans include in their benefit plans for employees and members. Continue reading
Last year on this blog, I asked a rhetorical question: Is value-based care a fad? I did not expect to get an answer. But in June I hosted a webcast on this topic and learned that value-based care is not a fad and that what health insurers and health care administrators call value-based care rarely delivers any actual value to patients or consumers.
Instead, when health insurers, physicians, and hospital and health system executives use the term “value-based care,” they most often mean value-based payment. Continue reading
In a report late last year, the Commonwealth Fund included two statistics about women’s health that were particularly startling.
In that report, “U.S. Women More Likely to Die in Pregnancy and Childbirth and Skip Care Because of Cost, Multi-Nation Survey Finds; C-Section Rates Rank Among Highest, the authors wrote that first, as many journalists have reported (such as Alison Young for USA Today and Nina Martin for ProPublica and Julia Belluz for Vox), pregnancy and childbirth are more dangerous for women in the United States than they are for women in other high-income nations. Continue reading
The Trump administration has been talking tough on drug prices for many months and, of course, pharmaceutical companies and other organizations have pushed back because they mostly oppose controls on the free market for prescription drugs.
For health care journalists covering these proposals, it’s essential to remain skeptical of any group that offers support or opposition and, as always, follow the money. Continue reading
To some of us, this procedure might have sounded too good to be true: A national network of infusion clinics offers to relieve just about any complication from diabetes, including neuropathy, nephropathy, cardiovascular problems and erectile dysfunction. It can do so as long as each diabetes patient enrolled is willing to sit for four hours every week or two while a pump pushes insulin through the patient’s veins.
Offered by Trina Health, this procedure was said to mimic the effect of the pancreas. But there was no data showing it worked; only testimonials from people who said they had been patients. But, to some desperate patients, it seemed plausible. Continue reading