Dec 15, 2023 | Managed Care Friday
$2.2 Billion: The estimated price tag for the first CRISPR gene-editing treatment for sickle cell disease approved by the FDA last week. But health systems, health plans, employers and patients all face potential challenges in paying for the potential cure. ICER says the price tag may be justified compared to the cost of lifelong treatment, but paying for a lump sum of that size all at once is something our healthcare system has been struggling with how to handle as more and more high-cost gene therapies continue to be approved. 4th & Goal: Tom Brady may be able to find new work. We...
Dec 8, 2023 | Managed Care Friday
348: The number of post-residency fellowships available in geriatric internal medicine available this year, but less than half of those spots were filled. The fill rate for geriatric family medicine was even lower, at 26.8%. Doctors specializing in geriatric medicine are increasingly in demand as the population ages, but younger physicians and those in medical school don’t seem to be interested in the specialty. Some of this could be due to low reimbursement compared to other specialties - in one of our polls of physicians in training in 2018, 73% said compensation would be a factor in their...
Dec 1, 2023 | Managed Care Friday
10%: The amount of all physicians in the US who are now employed or affiliated with UnitedHealth, according to the healthcare group’s investor day this week. That equals roughly 90,000 doctors who are part of the behemoth that includes a health plan, a PBM, a specialty pharmacy, and more. Drug Authorizations: Highmark BCBS will begin requiring prior authorization for 60 high-cost drugs in January 2024 for their Federal Employee Program (FEP) members. The change will move the medical necessity review from post-service to a pre-service review. And starting in January, BCBS Tennessee will no...
