Maryland

As the U.S. continues its efforts to overcome the COVID-19 pandemic amid a surge in cases caused by variant strains, staying safe is one of Americans’ top concerns. Safety is also essential for getting the economy back on track, as the lower COVID-19 transmission and deaths are in a state, the fewer restrictions there will be and the more confidence people will have to shop in person. While almost all states have fully reopened, we’ll only be able to completely get back to life as normal once most of the population is fully vaccinated against coronavirus. The good news is that the U.S.

Even as the supply of COVID-19 vaccines continues to increase, many doctors clamoring to distribute the vaccine directly to their patients are finding their requests go unheeded, experts say.

The Supreme Court on Tuesday dealt a fatal blow to an expansive Maryland law that aimed to bar drug makers from “price gouging” consumers.

The law, which the Maryland General Assembly passed in 2017, would have prohibited generic drug manufacturers from raising prices in a manner the state deemed “unconscionable.”

In a briefing on Tuesday February 12th, 2019, CareFirst’s president and CEO, Brian Pieninck discussed the future of healthcare and what role CareFirst will play in actualizing that future. One important part of the conversation was pharmaceutical costs, which is the highest cost category for CareFirst, making up 33 percent of their total spending. These costs are also rising faster than any other category and part of the problem is the opaque supply chain dynamic.

The future of U.S. health care reform is muddier now than at any point in the past two decades. Health care was one of the most important issues for voters in the 2018 election, but there is little reason to believe that substantive national action is likely any time soon. The Trump administration is taking aggressive steps to undermine the Affordable Care Act (ACA) but is limited in what it can do on health policy absent legislation from Congress. States are poised to fill this vacuum.

 Since it was launched in January 2011, the Patient-Centered Medical Home (PCHM) program operated by CareFirst BlueCross BlueShield (CareFirst) has lowered the expected cost of care for CareFirst members by nearly $1.2 billion.

In 2017 alone, CareFirst’s PCMH program – the largest coordinated care program of its kind in the country – helped save $223 million against the expected cost of care. The savings are fueled primarily by reductions in hospital admissions and readmissions and how long patients stay in the hospital once admitted.

“We had more imaging facilities than we really needed. Plus our ER was really crowded. So under a global budget we shut down one of our three imaging centers and converted it into a patient-centered medical home to reduce our ER volume.”

I wanted to pinch myself. Was this the fever dream of a crazy-eyed, hopeless delivery system reform devotee or was I really hearing a hospital executive say this? And how could he get away with it? Was he working hard to wreck his hospital’s finances and put himself out of a job?

In medicine, most people would likely agree that the goal should be making sure the patient is healthy and well, not earning revenue. Yet, in many places that isn’t necessarily the case when it comes to hospital admissions.