November/December 2011, Vol4, No7
Brett Pinsky, MPH, James Harnett, PharmD, Ryne Paulose-Ram, PhD, Jack Mardekian, PhD, Navendu Samant, PhD, Kavita V. Nair, PhD
Health plans are increasingly offering payment incentives to motivate providers to strive for improving the quality of patient care based on established criteria such as those set forth by the National Committee for Quality Assurance (NCQA).1,2
What Certification Really Means for Physician Quality
Section 3022 of the Patient Protection and Affordable Care Act of 2010 (ACA) calls for the Department of Health and Human Services to create the Medicare Shared Savings Program (MSSP) and other pilot programs to reduce healthcare costs while improving the quality of care.1 The ACA requires the Centers for Medicare & Medicaid Services (CMS) to launch the MSSP by January 1, 2012.2
The ACO Payment Model a Potential “Game Changer,” but Will It Improve Outcomes?
Sensitivity of Medication Use to Formulary Controls in Medicare Beneficiaries: A Review of the Literature
Rahul Shenolikar, PhD, Amanda Schofield Bruno, PhD, MPH, Christopher Cantrell, PhD, Michael Eaddy, PharmD, PhD
Patient access to healthcare resources is an important topic of healthcare discussion, research, and reform in the United States.1,2 Access issues are usually framed in the context of patients having health insurance, as the quality of health insurance facilitates patient access to necessary medical and pharmaceutical therapies.2 Although patient access to medications is essential, formulary management strategies may introduce barriers aimed at restricting utilization, including curbing patient demand by increasing the cost borne by the patient or providing incentives
We Need More Research on True Value-Based Benefit Design that Will Improve Outcomes and Control Costs
Incorporating new research findings into medical practice can take almost 2 decades according to estimates from the Institute of Medicine. Even when new research is published, clinicians tend to apply this knowledge inconsistently. The problem is most common in outpatient settings, particularly when providers are dispersed and have few opportunities to work in organized care teams in which new research may be more readily discussed and disseminated.
On October 31, 2011, President Obama directed US regulators to take actions that would help ameliorate the ever-critical shortage of drugs.1 Drug shortages exist in several therapeutic areas—most prominently in oncology and the problem does not appear to be abating on its own. Most shortages involve cancer and leukemia drugs, anti-infectives, anesthetics, emergency medicine drugs, antihypertensives, and electrolytes. The problem has become an increasing concern for all healthcare stakeholders patients, physicians, pharmacists, payers, and manufacturers.
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