Unbiased Analysis of Today's Healthcare Issues
Treating serious mental illness is not just a good thing to do for altruistic reasons. It also can improve health outcomes and reduce cost for those with comorbid physical conditions as well. Vincent Joralemon writes in Health Affairs Forefront regarding this issue. The article quotes Sherry Rais, CEO of Enthea: Ten percent of patients drive…
As reported by Kaiser Health News: The value of drugmakers’ copay cards has become more unpredictable as insurers try to restrict their use. Many insurance plans, for instance, do not count the money from a copay program toward a patient’s deductible.And patients who use a copay card can wind up paying full or nearly full price…
From a recent paper by Nasseh et al. 2026 in Health Services Research: Following acquisition, private equity-owned dental offices increased charges for dental care services by 3.3% (95% CI: 2.3%–4.4%), although allowed prices for these services remained statistically unchanged. Dental offices acquired by private equity firms tended to shift from diagnostic and preventive procedures to…
VaxImpactMap is an interesting online tool that quantifies the health and economic costs of declining childhood vaccination. The tool was developed by Mahmud Sheku, Connor Van Meter, Robert Bednarczyk, and Ben Lopman at Emory University Rollins School of Public Health. The tool focuses on changes these outcomes for three vaccine preventable diseases: Rotavirus, Pertussis (Whooping…
It turns out the answer is Medicare Advantage plans according to a KFF analysis released today. However the reason why Medicare Advantage is more profitable may not be obvious: At the end of 2024, gross margins per enrollee ranged from $608 in the Medicaid managed care market to $1,655 in the Medicare Advantage market. Gross…
FDA reverses its decision and will now review the Moderna flu vaccine. Could Australia be a model for FDA reform? “Pharma signals it’s done negotiating” Giant viruses. Hairy ball theorem.
After years of legislative debate, Congress has formally codified PBM reform into federal statute. Tucked within the Consolidated Appropriations Act, 2026 (H.R. 7148), signed on February 3, 2026 are structural mandates that will reshape Pharmacy Benefit Manager (PBM) operations in Medicare Part D and the commercial sector by 2028. The legislation targets three primary pillars:…
The number of hospitals owned by private equity (PE) firms has increased in recent years. One key question is how increased PE ownership has impact quality of care. To answer the question, a Jiao 2025 Health Services Research paper used claims Medicaid claims data–specifically data from the Transformed Medicaid Statistical Information System (T-MSIS) and Medicaid…
That is the findings from a KFF Health Tracking Poll out this month. The survey examines which aspects of accessing care and health insurance are the biggest problem for insured adults. The survey finds that 69% of adults believe prior authorization is a burden. Specifically, the survey asks “When it comes to getting health care,…
Expert opinions: Will MFN reduce US drug prices? Robots in maternity care. What drives company decisions on new medicine launches and UK investment? Incorporating dynamic pricing into HEOR models (dynamicpv) Tale of 2 value sets. How to handle the lows? Honesty. Integrity in journalism: Giannis edition.