Today's News and Commentary

About pharma

Pharma CEOs enthuse about Trump's plan to shake up drug rebates: As previously reported, the Trump administration seeks to give drug rebates to patients, not payers or PBMs. We know what PBMs think, but what about pharma companies. Apparently they are in favor of the proposal.

Read what pharma companies are saying

About healthcare IT

Greenway Health to pay $57M to settle claims it falsified EHR certification: Whom can you trust? This health IT company agreed to settle charges it falsified EHR certification for meaningful use. eClinicalWorks paid a fine for the same infraction in 2017.

Read the story

Telemedicine’s challenge: Getting patients to click the app: Initial barriers to telemedicine use were due to the healthcare system, namely reimbursement and physician licensure for those who saw patients in different states. These problems are being rapidly resolved. Now we are left with patient attitudes to using this technology. For those who want more immediate access but in-person care, walk-in clinics are now widely available. Some people also prefer a regular primary care physician. Still, this form of communication is expected to grow rapidly.

Read the story

About health insurance

Health Insurance Coverage Eight Years After the ACA: This research by the Commonwealth Fund has some mixed news about insurance coverage. Among the results:

“45 percent of U.S. adults ages 19 to 64 are inadequately insured — nearly the same as in 2010 — though important shifts have taken place.
Compared to 2010, many fewer adults are uninsured today, and the duration of coverage gaps people experience has shortened significantly.
Despite actions by the Trump administration and Congress to weaken the ACA, the adult uninsured rate was 12.4 percent in 2018 in this survey, statistically unchanged from the last time we fielded the survey in 2016.”

Read the study

Prior authorization hurdles have led to serious adverse events: Physicians don’t like prior authorizations because it takes time and is frustrating. But what is the effect on patients of this process? This AMA-sponsored survey raises some serious concerns. For example, 28 percent of respondents report “the prior authorization process required by health insurers for certain drugs, tests and treatments have led to serious or life-threatening events for their patients.” This survey raises at least a couple questions: Which, if any, prior authorizations add value to the care process? What if we changed the financial incentives to make prior authorization unnecessary, e.g., capitated systems where providers are financial responsible for these orders?

Read the AMA announcement
Read the survey results