Avalere assessed potential implications of step therapy on patients with employer coverage to examine total OOP and payer costs. Step therapy—also known as “fail first”—is a common form of utilization management that health plans use to control costs. Step therapy requires patients to try a preferred drug before gaining access to the drug prescribed by […]
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Advocacy
Protecting the Integrated Model of Care
High-quality, integrated care delivered in the independent medical practice setting is worthy of protection as an alternative to care that is often more costly when furnished in the hospital setting. Read more...
Saving the In Office Ancillary Service Exception (IOASE)
Integrated models of care allow for better coordination across specialties, translating into higher quality, lower cost and more accessible care for patients. Read more...
Pathology Services Utilization
Recent data, including 2009-2013 Medicare data relating to the cost and utilization of anatomic pathology (AP) services, demonstrates that the GAO report fails to tell the full story about cost and utilization. Read more...
Recent Advocacy
A DEI Reading List for Physicians
Dr. Linda Rae Murray, MPH, professor of Health Policy and Administration at the University of Illinois, Chicago, has created a book list about medicine. For a definitive look at the history of medicine and the Black community she recommends the two volume work by Byrd & Clayton (two African American physicians).
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Black Maternal Health Momnibus (H.R. 6142, S. 3424)
In the richest nation on earth, moms are dying at the highest rate in the developed world – and the rate is rising. For as dire as the situation is for all women, the crisis is most severe for Black moms, who are dying at 3 to 4 times the rate of their white counterparts.
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Community Immunity During COVID-19 Act (H.R. 8061)
The Community Immunity During COVID-19 Act, introduced by Congresswoman Lauren Underwood (IL-14), would provide robust funding to develop, scale, and evaluate local initiatives to boost vaccination rates during this pandemic. These investments will be particularly important for building confidence around an eventual COVID-19 vaccine once one has been proven to be safe and effective. Read […]
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Physicians, Patients Give Telehealth High Marks During COVID-19 Pandemic
Washington DC – A study in Clinical Gastroenterology and Hepatology suggests that telehealth services are an effective way to treat patients safely during periods of health care system disruption and shows that both patients and gastroenterology (GI) physicians overwhelmingly approve of telehealth services provided during the COVID-19 pandemic.
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