PatientEngagementHIT

Patient Responsibility News

Industry Players Spar Over Path to Address Surprise Medical Bills

March 20, 2019 - Hospitals are at odds with payer and healthcare business groups about how to address surprise medical bills, with both cohorts issuing statements on the matter. On March 18, payer industry leaders sent a letter to Congress outlining key issues that should be included in any legislation addressing surprise medical billing. Surprise medical billing occurs when a patient receives a set...


Articles

UnitedHealth Requires Drug Rebates to Cut Patient Drug Spending

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UnitedHealth Group and its pharmacy benefits manager (PBM) offshoot OptumRx will be expanding a year-old program set to deliver point-of-care drug rebates and discounts for patients, ideally cutting drug spending for consumers. The...

Out-of-Network Docs Charge More in ED, Spur Surprise Medical Bills

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Surprise medical bills and charges from out-of-network physicians total to nearly $6 billion annually, putting a significant strain on patient finances and out-of-pocket medical spending, according to a recent report from UnitedHealth...

Bill Targets Commercial Drug Rebates, Out-of-Pocket Patient Costs

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Proposed legislation would rework the rebates system for prescription drugs in the commercial health payer space, prohibiting rebates being passed from drug manufacturers to pharmacy benefits managers (PBMs). Instead, rebates savings...

High Premiums, Out-of-Pocket Costs Cripple Middle Class Enrollees

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Affordable Care Act (ACA) marketplace premium increases are proving unmanageable for middle-class enrollees, as high premiums and out-of-pocket costs prevent these individuals from purchasing health plans, according to a recent issue brief...

What Motivates Patients to Engage in Price Shopping, Consumerism?

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Better support from providers and health plans could motivate high-deductible health plan enrollees to engage in consumer behaviors, such a price shopping for the best value care, according to survey data published in the journal Health...

Lilly Drops Generic Insulin to Cut Out-of-Pocket Patient Costs

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Lilly has released a generic form of its insulin drug, cutting the list price in half and ideally reducing out-of-pocket patient costs. The drug manufacturer has created a generic form of Humalog, its insulin product. The generic form,...

Senate Hearing Targets Rising Out-of-Pocket Patient Drug Costs

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Tackling high out-of-pocket patient drug costs is a priority for healthcare policymakers and pharmaceutical companies alike, although key stakeholders hardly agree on how to get there. This and more came to light during a recent Senate...

Payer Accountability Key for Surprise Medical Bill Legislation

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Draft legislation addressing surprise medical bills must include provisions to hold healthcare payers accountable for narrow networks and limited transparency, according to a group of industry organizations led by the American Academy of...

Out-of-Pocket Patient Spend Soars as Utilization is Unchanged

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Healthcare costs and out-of-pocket patient spending is increasing, despite consistent healthcare utilization, according to the Health Care Cost Institute (HCCI) 2017 Health Care Cost and Utilization Report. The report, which looked at...

76% of Patients Benefit from Drug Price Transparency Technology

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Providing point-of-care drug price transparency may be getting closer to a reality, as more providers adopt the technology necessary to view such information, according to a Surescripts report released this week at HIMSS. Price...

How Can CMS Address Senior Poverty, Patient Healthcare Costs?

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Cutting patient healthcare costs will be a key step toward addressing senior poverty, which is ultimately a high priority for the Centers for Medicare & Medicaid Services (CMS), the agency said in a blog post. Late last month, the...

HHS Proposal Reforms Drug Rebates to Reduce Patient Spending

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HHS has proposed to eliminate drug kickbacks and rebates passed from manufacturer to pharmacy benefits manager (PBM), instead requiring those types of savings to be passed directly to patients. This is a part of the Department’s...

Specialty Drugs Rake in High Out-of-Pocket Costs for Part D Patients

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Medicare Part D enrollees with serious illness can expect extraordinary out-of-pocket healthcare costs as they seek drugs for their conditions, according to a recent analysis from the Kaiser Family Foundation (KFF). “The findings...

How Can Health Pros Address Cost as Medication Adherence Barrier?

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As healthcare professionals continue to push for better chronic disease management, they continue to face high healthcare costs as a primary medication adherence barrier. Numerous studies have indicated that drug costs serve as the...

Chronic Disease Management, Diabetes Patient Costs Up $6K

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Chronic disease management and treatment for individuals with type 1 diabetes can cost patients thousands of dollars each year, primarily due to the increasing cost of insulin, according to a recent report from the Health Care Cost...

Medicare Part B Drug Plan Could Raise Out-of-Pocket Patient Costs

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An HHS proposal to shift some Medicare Part B drugs to Medicare Part D may decrease overall drug spending, but it could increase out-of-pocket patient costs, data suggests. The HHS proposal would shift Part B drugs to Part D prescription...

Verma: Price Transparency Rule Critical First Step for CMS

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Healthcare organizations may only need to post chargemaster lists online for now, but that doesn’t mean they can’t create their own initiatives to improve price transparency, said CMS Administrator Seema Verma in a press call...

Out-of-Pocket Insurance Costs Challenge Pre-Medicare Patients

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The out-of-pocket costs of health insurance coverage is daunting for older adults who don’t yet qualify for Medicare, posing insurance and treatment access issues for this population, according to a recent AARP/University of Michigan...

Cerner Collaboration to Drive Drug Price Transparency in the EHR

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EHR vendor Cerner and CoverMyMeds, a health IT company that focuses on prior authorizations, have partnered to bring point-of-care price transparency to patient and provider. The partnership will put contextualized drug prices in front of...

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