By a wide margin, lung cancer is the most significant cause of cancer death in the United States and worldwide. The incidence of lung cancer increases with age, and Medicare beneficiaries are often at increased risk. Because of its demonstrated effectiveness in reducing mortality, lung cancer screening with low-dose computed tomography (LDCT) imaging will be covered without cost-sharing starting January 1, 2015, by nongrandfathered commercial plans. Medicare is considering coverage for lung cancer screening.
Cost-Effectiveness and the Medicare Budget
Medicare Part D, the senior prescription drug benefit plan, was introduced through the Medicare Modernization Act of 2003. Medicare beneficiaries receive information about plan options through multiple sources, and it is often assumed by consumer health plans and healthcare providers that beneficiaries can understand and compare plan information.
Understanding the Options: An Essential Ingredient in Our Evolving Healthcare System
Medication therapy management (MTM) is a mandated component of the 2003 Medicare Modernization Act for Part D prescription drug plans and Medicare Advantage plans, authorizing the pharmacist or other qualified provider to identify, resolve, and prevent medication-related problems for patients with chronic diseases. MTM programs have been shown to improve medication adherence and reduce medication errors while reducing overall costs in patients with cardiovascular (CV) disease; however, MTM has been greatly underutilized for patients with chronic diseases.
Hanging Together for Patient-Centered Medical Care

In recent years, drug shortages have become a common occurrence in hospital and retail settings, with a record high of 267 drug shortages reported in 2011.1 Julie A.

Drug Shortages in the United States Continue to Undermine Patient Care

Over time, the costs associated with the Medicare program have increased steadily and have contributed to the growth in national health expenditures.

Medicare Part D and the Federal Employees Health Benefits Program

With total health insurance costs at approximately 17% of the US Gross Domestic Product,1 a rapid growth rate, rising rates of chronic diseases, such as diabetes, and an aging population, changing the dynamics—the fundamental drivers—of the US healthcare is key. The 2010 Census estimates 16.3% of Americans do not have health insurance, and that the percentage of people with employment-based health insurance decreased from 56.1% in 2009 to 55.3% in 2010.2

Primary Care Shortages: It Is All About the Money After All

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?

As stakeholders continue to strive for greater value in the US healthcare system, many are calling for more research to inform treatment decisions, particularly for providers and patients choosing between available multiple interventions. This charge has helped to ignite interest in comparative effectiveness research (CER), which aims to provide evidence on the effectiveness, benefits, and harms of competing treatment options for a clinical condition.

Research and development (R&D) activities in an era of globalization encounter a mosaic of providers, products, services, and intermediaries; regulatory and other government institutions; and consumers. Within the next 10 years, new product introductions within the United States and Western Europe in particular must navigate through a labyrinth of payers and purchasers, address the realities of transparent pricing and rule-driven business practices, and provide research and data as a differentiator of sales and marketing initiatives.

Dalia Buffery: What changes can healthcare decision makers expect to see in the near future as a result of the recent national elections and their potential implications on the reform bill?

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