Does Medicare Reimbursement Drive Up Drug Launch Prices?

2020 ◽  
Vol 102 (5) ◽  
pp. 980-993 ◽  
Author(s):  
David B. Ridley ◽  
Chung-Ying Lee
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medicare Reimbursement ◽  
Care Providers ◽  
Drug Reimbursement ◽  
Perverse Incentive ◽  
The Past ◽  
Using Data ◽  
Past Price

Medicare reimburses health care providers for the drugs they administer. Since 2005, it has reimbursed based on the past price of the drug. Reimbursement on past prices could motivate manufacturers to set higher launch prices because providers become less sensitive to price and because provider reimbursement is higher if past prices were higher. Using data on drug launch prices between 1999 and 2010, we estimate that reimbursement based on past prices caused launch prices to rise dramatically. The evidence is consistent with the 2018 claim from Medicare's administrator that it “creates a perverse incentive for manufacturers to set higher prices.”

scholarly journals Queering whole person care in a pandemic

2022 ◽  
Vol 9 (1) ◽  
pp. 56-57
Author(s):  
Jane Shulman ◽  
David Kenneth Wright
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
The Past ◽  
Health Care Experiences ◽  
The People ◽  
Whole Person ◽  
Care Approach ◽  
The Face ◽  
Nursing Educator

How can health care providers (HCPs) working with 2SLGBTQ+ patients enact a whole person care approach during the SARS-CoV-2 pandemic and its aftermath, and in such desperate times, is it even reasonable to expect them to? In this presentation, a nurse/nursing educator and a health care researcher/frequent patient discuss their observations and experiences of whole person care during the SARS-CoV-2 pandemic. The conversation highlights that in the immediate chaos early on, and in the face of exhaustion, trauma, and burnout as the pandemic progressed, attending to the whole personhood of patients was/is paramount for HCPs and for the people they treat. The presenters reflect on the amplified significance of a whole person approach for 2SLGBTQ+ people who may have had negative health care experiences in the past, and may fear that they will not receive equitable care in the chaotic context of a pandemic. A whole person care approach is perhaps most necessary when it is also most difficult. In a period of such profound distress, a deeper sense of connectedness to patients may help HCPs manage feelings of helplessness they are likely to encounter, and surely helps the people they treat. The goal of this presentation is to begin a discussion about the ways that whole person approaches benefit 2SLGBTQ+ patients as well as their HCPs, with the hope that it will spark ideas for attendees to develop in their own practices.

scholarly journals Patient portals and personal health information online: perception, access, and use by US adults

2016 ◽  
Vol 24 (e1) ◽  
pp. e173-e177 ◽  
Author(s):  
Sue Peacock ◽  
Ashok Reddy ◽  
Suzanne G Leveille ◽  
Jan Walker ◽  
Thomas H Payne ◽  
...  
Keyword(s):  
Health Care ◽  
Health Information ◽  
Health Care Providers ◽  
Race And Ethnicity ◽  
Personal Health Information ◽  
Personal Health ◽  
Care Providers ◽  
Patient Portals ◽  
The Past ◽  
Patient Race

Background: Access to online patient portals is key to improving care, but we have limited understanding of patient perceptions of online portals and the characteristics of people who use them. Methods: Using a national survey of 3677 respondents, we describe perceptions and utilization of online personal health information (PHI) portals. Results: Most respondents (92%) considered online PHI access important, yet only 34% were offered access to online PHI by a health care provider, and just 28% accessed online PHI in the past year. While there were no differences across race or ethnicity in importance of access, black and Hispanic respondents were significantly less likely to be offered access (P = .006 and <.001, respectively) and less likely to access their online PHI (P = .041 and <.001, respectively) compared to white and non-Hispanic respondents. Conclusion: Health care providers are crucial to the adoption and use of online patient portals and should be encouraged to offer consistent access regardless of patient race and ethnicity.

scholarly journals The Use of Medical Records in Research: What Do Patients Want?

2003 ◽  
Vol 31 (3) ◽  
pp. 429-433 ◽  
Author(s):  
Nancy E. Kass ◽  
Marvin R. Natowicz ◽  
Sara Chandros Hull ◽  
Ruth R. Faden ◽  
Laura Plantinga ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Records ◽  
Medical Information ◽  
Personal Information ◽  
National Institutes Of Health ◽  
Care Providers ◽  
Electronic Information ◽  
The Past ◽  
Growing Body

In the past ten years, there has been growing interest in and concern about protecting the privacy of personal medical information. Insofar as medical records increasingly are stored electronically, and electronic information can be shared easily and widely, there have been legislative efforts as well as scholarly analyses calling for greater privacy protections to ensure that patients can feel safe disclosing personal information to their health-care providers. At the same time, the volume of biomedical research conducted in this country continues to grow. The budget of the National Institutes of Health, for example, was $20,298 million in 2001, having more than doubled from a budget of $9,218 million 10 years before. This growing body of research includes increased efforts to use stored medical records as a source of data for health services, epidemiologic, and clinical studies.

Unprofessional Practice? The Status and Power of Sport Physicians

2006 ◽  
Vol 23 (4) ◽  
pp. 376-395 ◽  
Author(s):  
Dominic Malcolm
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Sports Medicine ◽  
Rugby Union ◽  
Care Providers ◽  
The Status ◽  
Limited Power ◽  
Peculiar Character ◽  
Using Data ◽  
Workplace Setting

In this article I examine the role and working practice of rugby union club doctors in England. While medicine is widely perceived to be one of the most powerful professions in Western societies, sociologists of sport have argued that sport clinicians often wield relatively limited power over their athlete-patients. In this article I therefore attempt to shed further light on the “peculiar” character of sports medicine. Using data drawn from interviews and questionnaires, I argue that this phenomenon can be understood only by looking at the structure of the sports medicine profession, the specificities of the rugby club as a workplace setting, and the relationships club doctors have with clients (coaches and athletes) and other health care providers (physiotherapists).

scholarly journals Effect of Health Care Providers’ Focused Discussion and Proactive Education About Relapse Management on Patient Reporting of Multiple Sclerosis Relapse

2021 ◽  
Author(s):  
Royce W. Waltrip ◽  
Nancy Mahler ◽  
Alina Ahsan ◽  
Leslie B. Herbert
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Care Providers ◽  
Online Survey ◽  
Care Providers ◽  
Patient Reporting ◽  
Multiple Sclerosis Relapse ◽  
The Past ◽  
Disease Modifying Therapy

Abstract Background: Treatments for multiple sclerosis (MS) relapse include intravenous corticosteroids and repository corticotropin injection. Despite available treatment, in the Multiple Sclerosis in America 2017 survey, only 47% of patients reported always/often contacting their MS health care provider (HCP) during relapse. In this study, the Multiple Sclerosis in America 2017 survey participants who received intravenous corticosteroids or repository corticotropin injection for treatment of past relapses completed a follow-up survey to understand how patients characterize relapse severity and to explore predictors of patients contacting their HCP during a relapse. Methods: Patients were18 years and older, diagnosed as having MS by an HCP, and currently using disease-modifying therapy. Patients completed an online survey assessing relapse characteristics and interactions with the HCP treating the patient’s MS. Regression analysis identified predictors of patients contacting their HCP during relapse. Results: Mean age of the 126 respondents was 49.2 years, 81.0% were female, and most (80.2%) had one or more relapses in the past 2 years. Patients estimated that 38.3% of their relapses were mild; 45.1%, moderate; and 16.6%, severe. Number and frequency of symptoms increased with relapse severity. Less than half (46.0%) reported they were extremely likely to contact their HCP during a relapse. The best predictors of being likely to contact the HCP during relapse were the HCP having previously discussed the importance of immediately communicating a relapse and patients’ willingness to accept the HCP’s recommendation for relapse treatment. Conclusions: Findings highlight the importance of HCPs’ advance discussions with patients with MS regarding relapse management to increase the likelihood patients will contact their HCP during relapse.

Cigarette Smoking and Smoking Cessation among Persons with Chronic Obstructive Pulmonary Disease

2006 ◽  
Vol 20 (5) ◽  
pp. 319-323 ◽  
Author(s):  
Jeannine S. Schiller ◽  
Hanyu Ni
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Smoking Cessation ◽  
Pulmonary Disease ◽  
Health Care Providers ◽  
Activity Limitation ◽  
Chronic Obstructive ◽  
Care Providers ◽  
Obstructive Pulmonary Disease ◽  
The Past

Purpose. To identify factors predictive of smoking cessation among adults with chronic obstructive pulmonary disease (COPD). Data from the 1997 to 2002 National Health Interview Surveys were analyzed for adults at least 25 years of age with COPD using logistic regression. Results. Of the adults with COPD, 36.2% were current smokers. Of the current smokers and former smokers who had quit smoking during the past year, 22.9% reported not receiving cessation advice from a health care professional during the past year. Although half of smokers with COPD had attempted to quit during the past year, only 14.6% were successful. Attempting to quit was negatively associated with heavy drinking but positively associated with being younger and having cardiovascular diseases, lung cancer, and activity limitation due to lung problems. Factors predictive of successful cessation included being at least 65 years old, not being poor, and activity limitation due to lung problems. Conclusion. This study underscores the importance of continuing to develop smoking cessation strategies for COPD patients and implementing clinical guidelines on smoking cessation among health care providers.

Review of pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections

2015 ◽  
Vol 5 (4) ◽  
pp. 184-188 ◽  
Author(s):  
Sandy Mullen
Keyword(s):  
Health Care ◽  
Diagnostic Criteria ◽  
Health Care Providers ◽  
Neuropsychiatric Disorder ◽  
Background Information ◽  
Community Health Care ◽  
Streptococcal Infections ◽  
Care Providers ◽  
The Past ◽  
General Community

Abstract During the past decade, pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) has become the topic of numerous debates, sparking research on its presentation, existence, and treatment. As the awareness of PANDAS has increased among the general community, health care providers have been forced to increase their knowledge of this controversial disease state. This article will review the background information, diagnostic criteria, treatment, and contentious issues related to PANDAS.

Handoff Research

2016 ◽  
Vol 5 (1) ◽  
pp. 106-111 ◽  
Author(s):  
Lee Ann Riesenberg ◽  
Robyn Davis ◽  
Emma O’Hagan
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Nursing Students ◽  
Health Care Providers ◽  
Medical Errors ◽  
Complex Task ◽  
Care Providers ◽  
The Past ◽  
Current State ◽  
And Training

Handoffs, or the transfer of patient care from one provider to another, are a complex task which can both contribute to and prevent medical errors. In this article, we review three topics that illustrate what is good, bad, and ugly about the current state of handoff research. First, we examine the good, the increase both in quantity and variety of research into patient handoffs over the past 30 years. Second, we discuss what is lacking, funding for handoff research. Finally we review one of the most troubling aspects of handoffs, the general lack of education and training for medical students, residents, and nursing students, to prepare them to manage handoffs as health care providers.

Competitive Spillovers and Regulatory Exploitation by Skilled Nursing Facilities

2016 ◽  
Vol 19 (1) ◽  
pp. 45-70 ◽  
Author(s):  
John R. Bowblis ◽  
Christopher S. Brunt ◽  
David C. Grabowski
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Medicare Reimbursement ◽  
Care Providers ◽  
Skilled Nursing ◽  
For Profit ◽  
Market Dominance ◽  
Selection Of

Abstract Typically, research on the effect of ownership has considered health care providers in isolation of competitive interaction from other firms. This analysis considers how the selection of Medicare reimbursement codes for skilled nursing facilities varies by ownership and is influenced by the competitive spillovers from market dominance of for-profit institutions. We find evidence that not-for-profits are less likely to code patients into the highest reimbursement categories. Further, as the market becomes dominated by for-profits, both for-profit and not-for-profits increase the share of patients in these high reimbursement categories.

Dying on Hospice in the Midst of an Opioid Crisis: What Should We Do Now?

2018 ◽  
Vol 36 (4) ◽  
pp. 273-281 ◽  
Author(s):  
Jennifer Gabbard ◽  
Allison Jordan ◽  
Julie Mitchell ◽  
Mark Corbett ◽  
Patrick White ◽  
...  
Keyword(s):  
Mental Health ◽  
United States ◽  
Health Care ◽  
End Of Life ◽  
Health Care Providers ◽  
The United States ◽  
Care Providers ◽  
The Past ◽  
Opioid Crisis ◽  
Prevalence Of Pain

The current opioid crisis in the United States is a major problem facing health-care providers, even at the end of life. Opioids continue to be the mainstay treatment for pain at the end of life, with the prevalence of pain reported in up to 80% of patients and tends to increase as one gets closer toward the end of life. In the past year, 20.2 million Americans had a substance use disorder (SUD) and SUDs are disabling disorders that largely go untreated. In addition, the coexistence of both a mental health and SUD is very common with the use of opioids often as a means of chemical coping. Most hospice programs do not have standardized SUD policies/guidelines in place despite the increasing concerns about substance abuse within the United States. The goal of this article is to review the literature on this topic and offer strategies on how to manage pain in patients who have active SUD or who are at risk for developing SUD in those dying on hospice.

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