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Costs of Care . #highvalue

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Drug money: Cancer treatments cost as much as $33,000 a month, but fall well short of being wonder cures. The issue: Many new cancer drugs are prohibitively expensive but offer patients more hype than hope.

Drug money: Cancer treatments cost as much as $33,000 a month, but fall well short of being wonder cures

Possible solutions: Regulators should require more patient benefit before approving cancer drugs, and tie their prices to how much they improve treatment. For a group of desperately ill Canadians, the press release seemed to offer genuine hope. A drug just approved by Health Canada, it said, provided “an important new option” — a form of personalized medicine for the mostly younger, non-smoking patients stricken by a surprising sub-type of lung cancer. Only one element was missing from the 2015 release: any suggestion that Zykadia would actually make those people tangibly better. While an early stage study found the medicine shrunk tumours in about half of patients, there is no evidence – a footnote to the announcement conceded — it helps them live longer or improves their quality of life. Still, manufacturer Novartis charged a small fortune for the drug: about $122,000 a year.

National Post. How Economic Incentives have Created our Dysfunctional US Medical Market. In my new book “An American Sickness: How Healthcare Became Big Business and How You Can Take it Back,” I began with a list of 10 Economic Rules that seem to govern the Dysfunctional U.S.

How Economic Incentives have Created our Dysfunctional US Medical Market

Medical Market. Some readers reacted with disbelief: How could such seemingly callous and absurd-sounding principles form the underpinning of something as precious as our healthcare? So here, I’ve illustrated each of the 10 rules with some real-life examples from the book to show you how they do, indeed, come into play. What you’ll see is that the economic forces and incentives that motivate our health system often lead to medical practices that are not especially good for our health — or our wallets.

Report: U.S. Spends More Per Person On Health Care Than Any Country, Somalia Spends The Least : Goats and Soda. The United States spends the most on health care per person — $9,237 – according to two new papers published in the journal The Lancet.

Report: U.S. Spends More Per Person On Health Care Than Any Country, Somalia Spends The Least : Goats and Soda

Somalia spends the least – just $33 per person. Obviously, wealthy countries spend more on health than do poor countries. Overall, where does the money come from? There are three different stages as countries develop. Low-income countries spend the least on health, and the sources of that little bit of funding are international donors and people paying out of pocket. Get What We Pay For? Hospitalized patients treated by physicians who order more or more expensive tests and procedures are just as likely to be readmitted or to die as patients treated by doctors who order fewer or less expensive tests, according to research led by Harvard Medical School and the Harvard T.H.

Get What We Pay For?

Chan School of Public Health. The study, published in JAMA Internal Medicine on March 13, is believed to be the first to examine the impact of individual physicians’ spending patterns on patient outcomes. Get more HMS news here “If you spend more money on a car or a TV, you tend to get a nicer car or a better TV,” said study senior author Anupam B. Jena, the Ruth L. Leaked report offers window into the medical one percenters and ‘growing concern’ over MD pay inequity. Even among doctors, it seems, there is the one per cent and the rest.

Leaked report offers window into the medical one percenters and ‘growing concern’ over MD pay inequity

Inequity in physician income is a growing concern that could fuel a “breakdown in collegiality,” over-delivery of certain services and unwanted intervention by governments, warns an internal Alberta Medical Association document. The issue of “relativity” in doctors’ pay has percolated quietly for years throughout Canada, but the leaked report lays out the MD pay divide — and its potential fallout — with unusual frankness and detail. More than 400 of the province’s physicians bill over $1 million a year including overhead — while 4,000 doctors are billing $250,000 or less, notes the background paper, obtained by the National Post.

Variation in Physician Spending and Association With Patient Outcomes. Telehealth Makes Some Health Care More Expensive. Luciano Lozano/Getty Images Telehealth takes a lot of forms these days.

Telehealth Makes Some Health Care More Expensive

Virtual visits with a health care provider can take place by video, phone or text, or via the Web or a mobile app. The one commonality: You get to consult a doctor from your home, the office, Starbucks or anywhere with a wifi or mobile connection. Study Suggests High-Spending Doctors Could Do Less Without Harming Patients - WSJ. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. For these realities becomes that much more important as we move toward a bundled payment system, but today’s failures at patient engagement leave us far from the mark of where we need to be.

The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary

As an illustration, 4 years ago, one of my family members was diagnosed with a Stage 4 cancer, with a projected remaining life span of 120 days. Furthermore, there was less than a 30 percent chance that any intervention would be favorable. My family represents many well-informed healthcare consumers, and we asked the obvious questions, including “What are the costs for the care?” Yet, after 5 months, we still did not have an answer about the cost, and this was a family that was persistent, well educated, and well informed.

So as we begin to talk about bundled payments, we are indeed asking the nation to make a fundamental paradigm shift. Patients need information that they have never had before. Of course, bundling is not a brand new concept. The Strategy That Will Fix Health Care. In health care, the days of business as usual are over.

The Strategy That Will Fix Health Care

Around the world, every health care system is struggling with rising costs and uneven quality despite the hard work of well-intentioned, well-trained clinicians. Health care leaders and policy makers have tried countless incremental fixes—attacking fraud, reducing errors, enforcing practice guidelines, making patients better “consumers,” implementing electronic medical records—but none have had much impact.

It’s time for a fundamentally new strategy. At its core is maximizing value for patients: that is, achieving the best outcomes at the lowest cost. Health Affairs. Abstract Payment systems for health care today are based on rewarding volume, not value for the money spent.

Health Affairs

Two proposed methods of payment, “episode-of-care payment” and “comprehensive care payment” (condition-adjusted capitation), could facilitate higher quality and lower cost by avoiding the problems of both fee-for-service payment and traditional capitation. The most appropriate payment systems for different types of patient conditions and some methods of addressing design and implementation issues are discussed.

Breaking down Canada’s health-care silos: More money isn’t the answer - The Globe and Mail. Jason Sutherland is an associate professor in the Centre for Health Services and Policy Research in the UBC Faculty of Medicine, School of Population and Public Health.

Breaking down Canada’s health-care silos: More money isn’t the answer - The Globe and Mail

He co-wrote a paper with Erik Hellsten, titled “Integrated Funding: Connecting the Silos for the Healthcare We Need,” which was published by the C.D. Howe Institute. GP rebate: What I do for the $37.05 that no one wants to pay. The builder chatted while I checked his blood pressure, waist circumference, cholesterol, fasting glucose and urine protein. We discussed bowel and prostate cancer screening in detail and I gave him written information as we were out of time. As I signed his script for blood pressure medication he winked. "That was easy money for you, wasn't it? " This is a modal window. GetSharedSiteSession?rc=4&redirect= Billions wasted on drug spending in Canada, exclusive research shows - Health. Canada wasted $15 billion over the last five years on highly priced prescription drugs, in part because of questionable drug company sales tactics, according to exclusive research and a hidden camera investigation by the fifth estate.

John Herbert, a director for Express Scripts Canada, says money can be saved by Canadians and their employers choosing to take advantage of 'lower-cost, clinically effective medications.' (Express Scripts Canada ) Intervention Cost-Effectiveness: Overview of Main Messages - Disease Control Priorities in Developing Countries - NCBI Bookshelf. Costs and Consequences of Misdiagnosed Lower Extremity Cellulitis. Question What is the national health care burden of misdiagnosed lower extremity cellulitis in patients admitted to the hospital from the emergency department? Findings In this cross-sectional study that included 259 patients, 30% were misdiagnosed with cellulitis, of which 85% did not require hospitalization and 92% received unnecessary antibiotics.

Combining these findings with previously published data, cost estimates, and and projections indicate that cellulitis misdiagnosis leads to 50 000 to 130 000 unnecessary hospitalizations in the United States and $195 million to $515 million in avoidable health care spending annually. Meaning Misdiagnosis of lower extremity cellulitis is common and may lead to unnecessary patient morbidity and considerable health care spending. Harmful medication prescribing to Canadian seniors costs $419M a year - Health. More than one in three Canadian seniors fills a prescription for a risky medication that should be avoided in older patients, say researchers who estimate $419 million a year is spent on such drugs.

Many medications are appropriate to take before age 65, but as a person's metabolism changes, the same drugs can become riskier compared with other available treatments, geriatricians say. Inappropriate prescribing among seniors can result in hospital admissions and increased risk of death. Citizens' preferences on healthcare expenditure allocation: evidence from Greece - Xesfingi - 2015 - Health Expectations. Abstract Background of context Priority setting and resource allocation across various healthcare functions are critical issues in health policy and strategic decision making. As health resources are limited while there are so many health challenges to resolve, consumers and payers have to make difficult decisions about expenditure allocation.

Objective Our research focus on the (dis)agreement between citizens' preferences and actual public health expenditure across broad healthcare functions, on whether this (dis)agreement is persistent, on whether various demographic factors amplify this (dis)agreement and to derive useful implications for public health policies. The biggest source of waste in Canadian health care? The private, for-profit sector : Policy Note. Costs and Consequences Associated With Misdiagnosed Lower Extremity Cellulitis. How to Make the Affordable Care Act Affordable. Throughout the third and final presidential debate, Secretary Clinton and Mr.

Trump disagreed on nearly every issue, but they did agree on one thing: the Affordable Care Act (ACA) is not affordable. Beyond petri dishes: Social, economic issues that affect health need more attention - Manitoba. The Costly Paradox of Health-Care Technology. As an economist who studies health care, I find it hard to know whether to welcome or fear new technology. Surgeons can replace a heart valve with a plastic and metal one that unfolds once threaded through arteries—repairs that used to be made by cracking open the chest. Customized cancer drugs hold the promise of making fatal diseases treatable. At the same time, it’s depressingly common to hear projections of fiscal Armageddon as health-care spending drags the U.S. federal government into debt and wipes out any wage growth for the average American. Can cost-effective health care = better health care? Preventing Unnecessary Costs of Drug-Induced Hypoglycemia in Older Adults with Type 2 Diabetes in the United States and Canada.

National Expenditure For False-Positive Mammograms And Breast Cancer Overdiagnoses Estimated At $4 Billion A Year. Is robotic surgery worth the cost? Imagine a surgery, and you’re probably picturing a scene right out of Grey’s Anatomy: a surgeon leaning over a patient’s open chest, wrist deep in flesh, asking for a scalpel. But since the 1990s, there has been a push away from this type of open surgery towards minimally invasive surgery, where doctors make small incisions and thread long plastic tubes through the incisions into the area that they’re operating on. They then work through the tubes, with the help of long instruments and a small camera. After it was introduced, the benefits of minimally invasive surgery quickly became clear. It results in faster recovery times and shorter hospital stays – and has become the standard for many operations as a result. More recently, robotic surgery entered the picture, with at least two dozen robots currently in use across Canada.

“It’s like you’re playing a video game,” says Bob Kiaii, chair of cardiac surgery at Western University, who uses a robot often in his operations. Forster agrees. Association of Reference Pricing for Diagnostic Laboratory Testing With Changes in Patient Choices, Prices, and Total Spending for Diagnostic Tests. The Challenge of Defining Low-Value Care. Low-Value Health Care Services in a Commercially Insured Population. Placebo effect of medication cost in Parkinson disease. Life expectancy vs health expenditure over time. High-Value, Cost-Conscious Health Care: Concepts for Clinicians to Evaluate the Benefits, Harms, and Costs of Medical Interventions. For-profit hospitals mark up prices by more than 1,000 percent because there's nothing to stop them. Association Between Availability of a Price Transparency Tool and Outpatient Spending. When Is It Ethical to Withhold Prevention? Achieving Value in Primary Care: The Primary Care Value Model.

MEASURING LOW-VALUE CARE IN MEDICARE. From cost benefit to risk benefit? Small group of expensive patients account for most health spending - Health. Training Physicians to Provide High-Value, Cost-Conscious Care:  A Systematic Review. Injection sites such as Vancouver’s Insite are cost-effective, study shows. Article. How much money do we waste on useless health care? After Surgery, Surprise $117,000 Medical Bill From Doctor He Didn’t Know. Choosing Wisely: low value services, utilization, and patient cost sharing. Cost Effectiveness in Medicine is not a Dirty Word. Association between household food insecurity and annual health care costs. True cost of health care to average family is $11K per year: report.

The hidden waste in Ontario health care. Forum shares creative ways to cut health care costs. INFORMING DISINVESTMENT: COBALAMIN DEFICIENCY IN THE FATIGUED. Eliminating Waste in US Health Care.