Does physician-hospital integration reduce ACO cost?

The answer is ‘yes’ from a paper by Lin et al. (2024). Using 2009-2013 data from the Massachusetts All-Payer Claims Database, the authors measured physician–hospital integration within an accountable care organization (ACO) based on the proportion of primary care physicians (PCPs) in an ACO who billed for outpatient services with a place-of-service code indicating that…

Will IRA increase CMS drug spending?

Potentially so, argues Adam Fein of Drug Channels. There are two mechanisms for this. First, for drugs not covered in the maximum fair price negotiations, Fein argues that drugs with high list prices and large rebates would lead to more net savings compared to drugs with lower list price and rebates in part because in…

The BIOSECURE Act: Q&A

What is it? The BIOSECURE Act is a bill seeks to stop firms that receive federal funds from using select Chinese service companies. These include the genomics firms BGI, MGI, and Complete Genomics; and WuXi AppTec and WuXi Biologics. These firms are deemed by the bill as foreign “companies of concern”. Why does it matter?…

Helping the paralyzed move

Technology is amazing. From The Economist: Fourteen years ago, Melanie Reid, a journalist, fell off a horse and broke her neck. The injury to her spinal cord left her paralysed, limiting the function of her four limbs and torso—a condition known as tetraplegia. For more than a decade her left hand was incapable of either…

A primer on brand-name prescription drug contracting

The above is the title of a helpful primer from Kenney and Keast (2024). I summarize some key points below. Provide an overview of the pharmacy contracts between stakeholders in the healthcare ecosystem. How did the rise of health maintenance organizations (HMOs) impact pharmacy contracting? The Health Maintenance Organization (HMO) Act of1973 spurred the growth…

Trading off lives for self-driving car decision-making

From Habla et al. (2024): Using a representative survey with 1317 individuals and 12,815 moral decisions, we elicit Swedish citizens’ preferences on how algorithms for self-driving cars should be programmed in cases of unavoidable harm to humans. Participants’ choices in different dilemma situations (treatments) show that, at the margin, the average respondent values the lives…

Links

Rise in reported US maternal mortality rates largely due to change in measurement ChatGPT 4o and Khan Academy. FDA clinical trial snapshots: 2023. Do some Medicaid beneficiaries even know they are insured? Do PBMs reduce prices?

Risk compensation after COVID-19 vaccination

Could COVID-19 be more efficacious than effective? This could be the case if individuals receiving COVID-19 engaged in ‘risk compensation’. In short, without a COVID-19 vaccine, individuals may have refrained from travel and engaged in social distancing. After a COVID-19 vaccine, these same individuals could have been more likely to travel and less likely to…

CMS Guidance on IRA Price Negotiation: Part 2

What data do drug manufacturers need to submit to CMS as part of the IRA price negotiation? What data elements can they electively submit? The recent CMS guidance released May 3, 2024 outlines these elements. What mandatory data are manufacturers required to submit? On the mandatory side, drug manufacturers are required to provide CMS with…