Resources and insights to help you keep up with policy and market trends in a transforming healthcare ecosystem

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Op-Ed: Hospitals, Middlemen Inflating Healthcare Costs

To start, the NHE data shows spending on hospital care continues to grow faster than overall healthcare spending. This is especially notable considering hospitals enjoy perks that other stakeholders do not have access to, like $25 billion in annual tax breaks, and large prescription drug discounts ($16 billion in 2016 alone). The “340B Drug Discount Program” was enacted by Congress to help uninsured patients by providing eligible hospitals with steep discounts on prescription drugs. But the statute neglected to explicitly require that these discounts be passed on to patients, which has allowed 340B hospitals to profit from patients buying medicines at full cost even though the hospitals received enormous discounts for the drugs.

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Dr. Mike Kolodziej weighs in on whether a practice-based program that incorporates evidence-based clinical treatment pathways, an oncology certified nurse call program, and an introduction to advance care planning, all of which are supported by a collaborative payer sponsor, reduce costs associated with treating Medicare-age patients while improving the quality of care provided to patients?

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Michael Kolodziej, MD, and Louis Jacques, MD, discuss the implications of the proposed NCD on Next-Generation Sequencing for oncologists

The proposed NCD has generated a lot of discussion in the medical community. While this offers the potential to move things forward in precision medicine, there are several questions that remain to be answered. The Community Oncology Alliance, in collaboration with ADVI, a Washington, DC, consultancy that specializes in healthcare payment strategies, recently held a webinar discussion of the specifications and implications of the proposal, in advance of the end of the public comment period on the NCD.

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Lindsay Bealor Greenleaf discusses Medicare hospital payments with Bloomberg Law

“The administration could be putting its focus on alternative and value-based payment models, like accountable care organizations, where hospitals and doctors provide more coordinated care and attempt to reduce Medicare spending,” Lindsay Bealor Greenleaf, director at the health reimbursement and policy consulting firm ADVI, told Bloomberg Law Feb. 13. Greenleaf is in the Austin, Texas, office of Washington-based ADVI.

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