Emron Managed Care News 6-12-15

More flexibility, options under Medicare ACO final rule


For the most part, industry experts are pleased with the changes the Centers for Medicare & Medicaid Shared  Savings Program (MSSP), which provides more options and opportunities for accountable care organizations (ACOs) to participate in the risk-based shared savings initiative.
The 5 most common medications in the US and how to save on them


Prescription spending went through the roof in 2014 in the United States. As a nation, we spent over $374 billion on prescription drugs last year, according to the latest annual report by IMS Institute for Healthcare Informatics, a company that tracks health care spending and usage. That’s an increase of nearly $43 billion from 2013.


States zero in on ObamaCare rescue plan


It may be easier than expected for states to save their ObamaCare subsidies, if the Supreme Court rules against the law this month.
How Medicare Advantage plans can distinguish themselves from the herd


Large health plans that have a strong investment in the Medicare Advantage (MA) market may be in the best position to capitalize on this booming business, according to a Health Affairs blog posts.


New Breakthrough Drugs Will Cost the U.S. Government How Much Money?


As debate intensifies over the prices for prescription medicines, a new study suggests that 10 so-called breakthrough drugs – including some that have not yet been approved by the FDA – will cost the U.S. government nearly $50 billion over the next decade.


Many U.S. hospitals mark up prices 1,000 percent: study


Even the astronomical price markups that consumers regularly pay for, say, wine in restaurants pale beside those in some U.S. hospitals: The price for procedures is often 10 times the cost, according to a study published on Monday in the journal Health Affairs.


Obama: ‘The Affordable Care Act doesn’t need fixing’


President Barack Obama told reporters Monday morning at the G7 summit in Germany that the Supreme Court never should have heard the King v. Burwell case on the legality of federal Affordable Care Act subsidies.


20 percent of healthcare organizations on board with Next Generation ACOs


One-fifth of current accountable care organizations say they will participate in the new Next Generation ACO model, according to a surveys from the Healthcare Intelligence Network (HIN).


Pricey Drugs Prompt AMA to Ask FDA and FTC for Help


Jerry D Kennett, MD, stepped up to the mic, pulled a pill out of his pocket — a new, extended release formulation of an irritable bowel syndrome (IBS) drug that costs $10.75 a dose — twisted open the opaque capsule and poured out a single tablet, which was the old “formulation” that had cost just pennies when it was on the market.


Popular Heartburn Meds Linked to Higher Risk of Heart Attack


People who use certain heartburn drugs for a long period of time may have a slightly heightened risk of suffering a heart attack, a new study suggests.


Walgreens, insurers push expansion of virtual doctor visits


Millions of people will be able to see a doctor on their smartphones or laptops for everyday ailments once the nation’s largest drugstore chain and two major insurers expand a budding push into virtual health care.
California’s ACOs: A model for the nation?


California’s successful accountable care organizations (ACOs) could offer valuable lessons for rest of the nation, which has seen mixed results with ACOs,according to California Healthcare.


Many Patients Find Unexpected Medical Bills, Even With Obamacare


Some states are trying to stem the bills for consumers who face high costs for getting care from out-of-network providers. Elsewhere, KHN looks at high insurance rate hikes, Ted Cruz fights his own party on health law subsidies and President Barack Obama takes to TV to defend the law.


FDA Approves First-Ever Concentrated Mealtime Insulin


Lilly just announced that the FDA has approved its Humalog 200 units/mL KwikPen (insulin lispro) for type 1 and type 2 diabetes, making it the first concentrated mealtime insulin analog to reach the US market. The pen has already been launched in Europe following its approval there last October.


FDA Advisers Recommend Approval of First of 2 New Cholesterol Drugs


U.S. health experts voted on Tuesday to recommend approval of the first of two drugs in a new class of cholesterol medications that sharply cut “bad” LDL cholesterol in people who don’t fare well on statins.