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Drug Benefit Trends

Drug Benefit Trends

With the country’s greatest number of uninsured residents, the largest public insurance program, and one of the lowest rates of physician reimbursement, California is struggling to provide health care to the 6.5 million people who need it.

Comparative Effectiveness Research: Let’s Look at Those Rationing ChargesWho should oversee comparative effectiveness research? How should the information it produces be promulgated to physicians? And is there any basis for charges that CER will lead to health care rationing?

Limiting benefits and requiring higher out-of-pocket costs for patients with mental health or substance use disorders is a practice that group health insurance plans must abandon, according to new rules issued by the US government.

By 2012, federal and state programs will pay slightly more than half of the nation’s health care costs whether or not any health care reform measures are passed, according to a recent report by the Office of the Actuary of the Centers for Medicare & Medicaid Services.1 As expected, the shift to a government-dominated health care sector is approaching faster than expected because of an economy in recession and because of the aging of the baby boomers, millions of whom will soon start signing up for Medicare.

Changes to Medicare’s reimbursement plans have inadvertently cut payments to cancer specialists, causing many cancer care centers to lose money and possibly close, according to results of a study commissioned by the Community Oncology Alliance (COA), an advocacy group for oncologists who practice outside of large hospital centers.1


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