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Health Care Reform — Where Do We Go from Here?

"Interpreting Hazards: The Increasing Importance of "Antidote to Anecdote" in Managed Care" by Fairman et al

"Is "Value-Based" Value Wasted? Examining Value-Based Insurance Designs Through the Lens of Cost-Effectiveness" by Melnick et al

58% of Surgeries Performed in Hospitals are Outpatient, According to AHRQ/HCUP survey.

AHRQ Introduces New Online Technical Tutorial Series With First Module on HCUP Sample Design

Doctors Face 21% Cut In Medicare Payments.

AMCP Issues Summary of White House Health Care Reform Summit

Maximus To Continue Reviewing Medicare Part D Plan Coverage Determinations

Pharmacoeconomics to Get Bigger Budgets, According to Preliminary Survey Results (Source=Marketwire)

Healthcare Rationing by Proxy: Cost-Effectiveness Analysis and the Misuse of the $50,000 Threshold in the US by Bridges et al.

The AMCP Format for Formulary Submissions, Version 3.0

Statistical Data Resources from AMCP for benchmarking in managed care

UnitedHealthcare has launched an innovative program that offers $20 discounts off certain prescription drug co-payments

Healthcare Technology News: National Health Expenditures Top 17% of GDP

UnitedHealthcare Creates Adult National Cancer Care Registry with Data and Analysis to Support Oncologists in the Fight against Cancer

Novartis’s Afinitor Cancer Drug Rejected by U.K. Cost Agency

NEJM: “Giving Teeth to Comparative-Effectiveness Research — The Oregon Experience” by Saha et al.

Oncology Innovative Pricing deal with NICE on lung cancer drug

“Medication Adherence and Enrollment in a Consumer-Driven Health Plan” by Chen,

FDA News: NICE Outlines Appeals Process for Drug Determinations

IBI: More Than Health Promotion: How Employers Manage Health and Productivity

PR Hub: NICE Recommends Approval of New Rheumatoid Arthritis (RA) Treatment Cimzia(R) (certolizumab pegol) With First of its Kind RA Patient Access Scheme

Healthcare Technology News: Privacy Survey - In Providers We Trust

NEJM article: ‘ Uncomfortable Arithmetic — Whom to Cover versus What to Cover’ by K. Baicker and A. Chandra

NEJM article: ‘ “Play-or-Pay” Insurance Reforms for Employers — Confusion and Inequity’ by B. Herring and M.V. Pauly

Centre for Reviews and Dissemination: Cost-effectiveness of interventions to promote physical activity: a modelling study

Do Health Politicians Really Listen to Health Economists? Observations from Europe by Mittendorf et al.

The Hospitalist: Evidence-Based Medicine Curveball

Health Care Reform and the Need for Comparative-Effectiveness Research

January 2010 Newsletter and Eisenberg Conference Series 2009 Are Now Available

Disease Management Care Blog: 10 Predictions for the Next Decade

Managed Care Vendor Sales Insight Article: Blue Cross Plans Join Initiative To Increase Transparency

Conference: Patient Experience and Patient Safety Culture, April 19-21

Funny Pharmacy Videos. These are Hysterical! Particularly "The PharmG's - Boom Intervention" Rap

Job Title Company

Director Pharmacoeconomist SXC Health Solutions

Medical Writer PRMA Consulting Ltd

PRACTICE LEADER/SENIOR DIRECTOR, HEALTH ECONOMICS AND OUTCOMES RESEARCH Boston Health Economics, Inc.

ASSOCIATE DIRECTOR, CV/MET, GHEOR Bristol-Myers Squibb

Analysts & Consultants PRMA Consulting Ltd

A Prescription for Change: How the Medicare Act Revises Hatch-Waxman to Speed Market Entry of Generic Drugs

The author reviews the pharmaceutical industry's patenting process as it has been impacted by the Hatch-Waxman and Medicare legislation which expedite review and approval for generic follow-on drugs. (Source: Stephanie Greene, Journal of Corporation Law, Winter 2005, last revised Oct 2009)

Ad Audit: How Close Is The Message To The Truth About Pending Health Bills And Medicare?

Kaiser Health News staff writer Jordan Rau examines a new ad by a conservative advocacy group that warns that the health care bills now before Congress would hurt Medicare. He finds that the ad uses older Americans to exaggerate the impact of proposed Medicare cuts and ignores some improvements (11/4).

After Reform Passes

So, how well will health reform work after it passes? (Source: Paul Krugman, NYT, Oct 25, 2009)

AHRQ 2009 Annual Conference

To help advance its goal of improving health care for all Americans, the Agency for Healthcare Research and Quality (AHRQ) held its third annual conference on September 13-16, 2009, in Bethesda, MD. This conference was designed to showcase the best of the Agency's research and provide examples of how that research is being implemented at all levels in health care delivery. Entitled "Promoting Quality... Partnering for Change," the conference featured presentations in seven major themes. Click for some relevant presentations.

AMCP Releases Summary Of Proposed Medicare Part D Rule

In the Oct. 22nd Federal Register, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule calling for a significant number of policy and technical changes to Medicare Advantage and stand-alone Part D prescription drug plans.

AMCP Review of Health Care Reform Legislation (Part 1)

Part 1 of the video explains provisions related to the Medicare Part D drug benefit, while Part 2 explains other provisions relevant to managed care pharmacy.

AMCP Review of Health Care Reform Legislation (Part 2)

Part 1 of the video explains provisions related to the Medicare Part D drug benefit, while Part 2 explains other provisions relevant to managed care pharmacy.

Baucus Bill Gives Industry Larger Role in CE Research

Each of the three major health care reform bills now before Congress contains a major section establishing the U.S.'s first comparative effectiveness research agency. (Source: GoozNews ~ 28 Sep 2009)

Baucus’s Bill and the Long Road to Reform

"...the administration considers Baucus’s bill the most promising vehicle for crafting a compromise, because it is less costly than the alternatives approved by four other congressional committees and is the most palatable to influential private stakeholders." (Source: John K. Iglehart, NEJM, September 23, 2009)

Comparative-Effectiveness Research Could Find New Uses for Drugs

Comparative-effectiveness research (CER), provided for in congressional healthcare overhaul legislation, can fill in the gaps left by standard clinical trials by pinpointing subpopulations that respond to a particular drug, an expert says. (source: FDANews, Nov. 16, 2009)

Congressional Budget Expert Says Preventive Care Will Raise -- Not Cut -- Costs

Douglas W. Elmendorf, director of the Congressional Budget Office, offered a skeptical view Friday of the cost savings that could result from preventive care. (Source: Jake Tapper, ABC News, Aug. 9, 2009)

Drug Makers Raise Prices in Face of Health Care Reform

Critics say the industry is trying to establish a higher price base before Congress passes legislation that tries to curb drug spending in coming years. (Source: Duff Wilson, NYT, Nov. 15, 2009)

Ensuring Progress in Primary Care — What Can Health Care Reform Realistically Accomplish?

Dave A. Chokshi, M.D. In the current political environment, forging consensus on health care reform has proven challenging. Yet the value of a strengthened primary care infrastructure is one apparent zone of agreement among policymakers. Read more

Expert Panels Won't Improve Health Care

Dr. Norbert Gleicher in The Wall Street Journal roundly criticizes the proposed role of expert panels that would make determinations about what treatments to cover by using comparative-effectiveness research. (Source: Gleicher,Wall Street Journal, Oct. 18, 2009)

Filling the Information Needs for Healthcare Reform

To help meet the information needs of health care reform, and to inform our own work, the Agency for Healthcare Research and Quality (AHRQ) convened a small group of policymakers, researchers, and producers of health care data. The purpose of the meeting was to begin developing a strategy to optimize the availability of information and data for enactment and implementation of health care reform. (Source: AHRQ, July 2009)

Filling the Information Needs for Healthcare Reform

Filling the Information Needs for Healthcare Reform: Expert Meeting Summary and Identification of Next Steps. (Source: AHRQ, July 2009)

Four Health Care Reforms for 2009

Prospects for the enactment of some reform look good, but comprehensive, sustainable reform of the health care system must wait for another day. (Source: Victor Fuchs, NEJM, oct 2009)

Four Health Care Reforms for 2009 (NEJM article)

Prospects for the enactment of some reform look good, but comprehensive, sustainable reform of the health care system must wait for another day. Republican support for President Barack Obama’s ambitious agenda is fading fast, if it ever existed. An imaginative, truly bipartisan approach that moves the system away from employer-sponsored insurance — the Wyden–Bennett plan — has failed to gain any traction. Read more

Getting to the Real Issues in Health Care Reform

This article offers a discussion on the public option being debated in health care legislation. (Source: Ginburg, NEJM, Nov. 11. 2009)

Getting to the Real Issues in Health Care Reform

Getting to the Real Issues in Health Care Reform (Source: Paul B. Ginsburg, Ph.D, NEJM • November 11th, 2009)

GPs would get new incentives to treat diabetes under Nice proposals

GPs would get new incentives to treat diabetes under NICE proposals. (Source: TheTimesOnline, Aug. 10, 2009)

Grassley Votes Against Motion to Proceed with Health Care Bill

Grassley's opposition to the health care reform bill are provided in summary, and in full text of his floor speech. (Source: The Iowa Republican, Nov. 22, 2009)

Has the influence of managed care waned? Evidence from the market for physician services

This study examines the evolving nature of managed care and its restrictive effects on the provision of physician services. (Source: International Journal of Health Care Finance and Economics, Sept. 16, 2009)

Health Care Cartoons

As the health reform debate has heated up, editorial cartoonists have sharpened their pencils and gotten to work. Click thumbnails to enlarge.

Health Care Reform — A Republican View

Health Care Reform — A Republican View. (Source: Charles Grassley, NEJM, Nov. 18, 2009)

Health Care Reform 2009

NEJM edition dedicated to covering the Health Care Reform debate. (Source: NEJM, 2009)

Health Care Reform and the Need for Comparative-Effectiveness Research

Health care reform will eventually pit the goal of expanding health insurance coverage against strong pressure to reduce the growth in health care costs. If left to measures in the proposed reform legislation, cost containment will be driven primarily by marketplace incentives, programmatic initiatives, and organizational changes that would partially offset the costs of expanding coverage. These proposed economic policy changes and incentives, however, are not guaranteed to lead either to individual clinical decisions that will be in patients’ best interests or to enhancement of the public’s health. (Source: Alvin I. Mushlin, M.D., and Hassan Ghomrawi, Ph.D., M.P.H., NEJM, Jan. 6, 2010)

Health Care Reform and the Need for Comparative-Effectiveness Research”

Health Care Reform Bill Must Read Paragraphs

This article looks at the current health care reform legislation, espeically in terms of personal privacy and choice. (Source: The Health & Wellness Institute, PC, Juice Plus+ Healthnews, Nov. 23, 2009)

Health Care Reform Series: The French health care system

This article continues a comparative look at countries that have implemented the Bismarck model of health care, which emphasizes a mixture of private and public administration to deliver services. (Source: Jenny Kakasuleff, examiner.com, Aug. 8, 2009)

Health Care Reform: How are other countries doing?

Health Care Reform: How are other countries doing? Doctors and patients review foreign medical systems. (Source: Adam Aasen, NewsJacksonville.com, Aug. 22, 2009)

Health Care Reform: US vs Singapore

As the politics of the US continues to grind on around providing all Americans with the basics of health care, the government of Singapore has put together a panel of some of the world’s top designers to reshape it’s already terrific medical system so that it attracts people from all over the world to its facilities—and makes high value medicine a 21st century industry. (Source: Bruce Nussbaum, Busienss Week, November 22, 2009)

Health Insurance Reform and Breast Cancer: Making the health care system work for women

This report discusses the various problems with the current health care system for women who have breast cancer, and what solutions will be found through health care reform.

Health Insurance Reform and Breast Cancer: Making the Health Care System Work for Women

This report discusses access to healthcare for women with breast cancer. (Source: Julie Chang, Office of Health Reform, Department of Health and Human Services Meena Seshamani, MD, PhD, Director of Policy Analysis, Office of Health Reform, Department of Health, Healthreform.gov, Oct. 2009)

Health Insurers at the Table — Industry Proposals for Regulation and Reform

Health Insurers at the Table — Industry Proposals for Regulation and Reform (Source: Karen Ignagni, NEJM, Sept. 17, 2009)

Health Policy Doctoral Candidate's editorial in Huffington Post offers view on expert panels

DB Wright comments on a recent editorial by Dr. Norbert Gleicher in The Wall Street Journal that roundly criticizes the proposed role of expert panels. (Source: D. Brad Wright, Huffinton Post, Oct 2009)

Hong Kong: LCQ8: Development of the Chinese medicine industry

In his Policy Address delivered recently, the Chief Executive has proposed to promote the development of Chinese medicine and facilitate its development by introducing new certification services, making Hong Kong a stage for promoting Chinese medicine to the world. (Source: Webnewswire, Nov. 18, 2009)

How to Think Constructively About Healthcare

HarvardBusiness.Org article provides excellent graphics and comparators re health reform: How to Think Constructively About Healthcare. (Source: Umair Hague, HBR Guest Edition, Aug. 5, 2009)

Human’s CIO discusses health IT future

Bruce Goodman of Humana forecasts the impact of ICD-10, real-time claim adjudication, and role of health insurers in health reform. (Source: WSJ, Nov. 16, 2009)

ICD-10 Implementation Should begin by January 18, 2010

The timeline was developed by the NCHICA-WEDI Timeline Initiative, a collaboration of provider, health plan and vendor representatives serving on several workgroups. It details the steps and time required for each industry segment (providers, plans and vendors) to effectively implement this major change in how the healthcare industry identifies diagnoses and inpatient hospital procedures. (Source: Healthcare Technology News, Aug. 10, 2009)

Industry Has Influence In Reform Bill's Research Institute

Little attention has been paid to the actual language of the Senate bill with regards to comparative effectiveness research. It is notable to report that the bill repeats several times that the findings from government-funded research into the comparative effectiveness of various treatments will not be used to determine coverage or reimbursement under government health programs. (Source: Ken Terry, BNET, Dec. 7, 2009)

Keating: Economists shouldn’t back health care

This opinion challenges ideas presented in a letter by 23 economists sent to President Obama. (Source: "The Debate Room", Long Island Business News, Nov. 23, 2009)

Keeping the Patient in the Equation — Humanism and Health Care Reform

This article addresses the influence of growing interest in humanism and comparative effectiveness on health care reform. (Source: Pamela Hartzband, M.D., and Jerome Groopman, M.D, NEJM, Aug. 5, 2009)

Lost in Transmission — FDA Drug Information That Never Reaches Clinicians (NEJM article)

By Lisa M. Schwartz, M.D., and Steven Woloshin, M.D. The 2009 federal stimulus package included $1.1 billion to support comparative-effectiveness research about medical treatments. No money has been allocated — and relatively little would be needed — to disseminate existing but practically inaccessible information about the benefits and harms of prescription drugs. Much critical information that the Food and Drug Administration (FDA) has at the time of approval may fail to make its way into the drug label and relevant journal articles. Read more...

Making Health Care Better

NYT Columnist, David Leonardt, poses one of the more disturbing questions of the health care debate: "If politicians cannot fix America's fragmented, ailing health care system, who will?" (Source: NYT Magazine, David Leonhardt, Nov 3, 2009)

Medicaid and National Health Care Reform

This article discusses the role of Medicaid in Health Care reform. (Source: Sara Rosenbaum, J.D., NEJM, Oct. 14, 2009)

MS drugs scheme fails to deliver results

A pioneering scheme designed by government to impose a money-back guarantee on pharmaceutical companies if their drugs did not adequately treat patients has failed to provide any clear conclusions more than seven years after it was launched. (Source: The Health Economics Blog / The Financial Times, Dec. 4, 2009)

NEJM: Controlling U.S. Health Care Spending — Separating Promising from Unpromising Approaches

High U.S. health care spending has been characterized not only as a barrier to affordable insurance but also as the preeminent long-term threat to the economy and the competitiveness of American business. The current policy discussion in Congress does not address this problem.

New Study Shows Healthcare Costs Put U.S. Workers At Big Disadvantage

The costs and performance of the U.S. healthcare system have put America’s companies and workers at a significant competitive disadvantage in the global marketplace, according to a study by the Business Roundtable. (Source: Business Roundtable.org)

Perspective Roundtable: The Cost of Health Care

Video of Roundtable: President Barack Obama has argued that health care reform is essential to the future economic health of the United States. But the economics of both health care and reform are daunting. Is it possible to pay for health care coverage for all Americans without moderating our rapidly rising health care costs? (Source: Atul A. Gawande, M.D., M.P.H, Elliott S. Fisher, M.D., M.P.H., Jonathan Gruber, Ph.D., and Meredith B. Rosenthal, Ph.D, NEJM, October 14, 2009)

Perspective Roundtable: The Cost of Health Care

Primary Care and Accountable Care — Two Essential Elements of Delivery-System Reform (NEJM article)

Diane R. Rittenhouse, M.D., M.P.H., Stephen M. Shortell, Ph.D., M.P.H., M.B.A., and Elliott S. Fisher, M.D., M.P.H. With discussions about U.S. health care reform focused heavily on insurance reforms, relatively little attention has been paid to the delivery-system reforms that will be required to improve the quality and coordination of health care and slow the growth of spending.

Privacy Survey -- In Providers We Trust

Ponemon Institute published their study surveying American opinions on privacy of their health information. They found: 71% of Americans trust their providers with their medical information much more than they trust payers (43%), state and local government (31%), private information technology companies (27%) or the federal government (27%). (Source: Health Care Technology News, Feb. 1, 2010)

Risk Evaluation and Mitigation Strategies

REMS for drug products may affect marketing and access. Free article download. (Source: Risk Management, Sept 2009)

Robert Wood Johnson Foundation

The mission of the Robert Wood Johnson Foundation is to improve the health and health care of all Americans. Our goal is clear: To help Americans lead healthier lives and get the care they need.

Role of Evidence-Based Medicine in Informing Clinical Decision-Making Addressed by American College of Physicians in House Testimony

This article provides a summary of testimony that Donna Sweet, MD, MACP provided on Dec 2, 2009 to the Subcommittee on Health of the House Energy and Commerce Committee. She addresses the recent breast cancer screening guidlines. (Source: ACP - American College of Physicians, Dec. 2009)

Senate health care bill: the five paragraphs you must read

Buried in the Senate's 2,074-page health reform bill are provisions that undermine your health freedom and privacy. (Source: Sue Blevins & Robin Kaigh, The Christian Science Monitor, Nov. 23, 2009)

Side by Side Comparison of Major Health Care Reform Proposals

This side-by-side compares the leading comprehensive reform proposals across a number of key characteristics and plan components. (Source: The Henry J. Kaiser Family Foundation, Oct. 15, 2009)

Single-payer supposition: Medicine should save lives

This editorial raises ethical issues related to findings that trauma patients without insurance are 80 percent more likely to die than those with insurance. (Source: DR. PETER MAHR, My Oregon, Nov 24, 2009)

Study finds Medicare prescription benefit program has exceeded expectations

The program created to provide Medicare recipients with prescription drug benefits exceeded expectations during its first two years, extending pharmacy coverage to most seniors while reducing their overall spending on drugs, according to a new RAND Corporation study. (Source: RAND, Aug. 2009)

Systemwide Cost Control — The Missing Link in Health Care Reform

Successful health care reform requires effective control of health care spending — without it, rising costs will continue to strain federal and state budgets, businesses, and families, jeopardizing gains in insurance coverage. (Source: White, NEJM, Sept. 17, 2009)

The Economic Costs of Uninsured Children

In June, Rice University's James A. Baker III Institute for Public Policy released "The Economic Impact of Uninsured Children on America," a new report whose bottom line is that extending health insurance coverage to all children in the United States would be relatively inexpensive compared to the cost of letting children remain uninsured and would yield economic benefits that are greater than the costs. (Source: Marian Wright Edelman, The Huffington Post, Aug. 24, 2009)

The Economic Impact of Uninsured Children on America

The Economic Impact of Uninsured Children on America. (Source: Published by the James A. Baker III, Institue for Public Policy of Rice University)

The Public-Health Fallocy

Jonathan comments on a discussion indicating that the most important issue at hand in the health care reform debate is "who gets to make the decision" regarding type of care. (Source: Jonathan, Chicagoboyz.net, Nov. 22, 2009)

The Quality and Outcomes Framework (QOF)

Earlier this year, NICE was given the power to oversee the review of clinical and health elements of The Quality and Outcomes Framework (QOF). They have recently proposed a list of potential new indicators for QOF, and are awaiting negotiations between NHS employers and the British Medical Association who have the final say. (Source: PharmaTimes)

The White House Deal with Big Pharma Undermines Democrasy

Hard hitting article: Obama's agreement with Big Pharma may help healthcare reform pass, but it may also mean higher drug prices for you. (Source: Robert Reich, Salon.com, Aug. 10, 2009)

Urban Institute Health Policy Center

Undertakes economic and social policy research. Health Policy Center located at http://www.urban.org/health_policy/ Many reports on health reform

Weekly Address: Myths and Morality in Health Insurance Reform

Videop -- Weekly Address: Myths and Morality in Health Insurance Reform. (Source: Jesse Lee, White House Health Care Blog, Aug. 22, 2009)

Why Paying for Health Care Reform Is Difficult and Essential — Numbers and Rules

Why Paying for Health Care Reform Is Difficult and Essential — Numbers and Rules (Source: Henry J. Aaron, Ph.D, NEJM, Sept. 17, 2009)

Why You Should Be Very Worried About Government Health Recommendations

Aaron opines that the government policy decisions will be reflected as insurance coverage constraints limiting health care choice. (Source: Aaron Opine Blog, Nov. 21, 2009)

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