In a blog post[2] on price transparency tools, Devon Herrick of the National Center for Policy Analysis discusses findings from a recent RWJF-funded study[3] from Jon Gabel, M.A., and colleagues at NORC, that foun
As retail clinics grow in number, they are also expanding the services they offer, going beyond urgent care toward population health and chronic disease management services. As Jeff Lagasse discusses in Healthcare Finance[10], some hospitals and health systems have looked to partner with retail clinics while others have opted to compete with them directly, opening up their own clinics.
Under reference pricing, insurers set a reimbursement limit for medications and services, and patients pay out-of-pocket anything above that limit. In the United States, some health plans are using reference pricing for surgical and diagnostic procedures.
Commonly used in Europe for medications, reference pricing is a mechanism by which insurers reimburse a patient’s medication or health care service up to a certain limit, and the patient pays the rest out of pocket if the price charged is higher. The mechanism incentivizes patients to choose medications or services as close to the reference price as possible to reduce their own spending.
In a recent piece for The American Journal of Managed Care[19], Niteesh Choudhry, M.D., Ph.D., Harvard Medical School, discusses how high-deductible health plans (HDHP) can benefit from the use of value-based insurance design (VBID). He explains that one of the desirable effects of HDHPs is a shift among patients away from expensive medications to lower-cost medications like generics.
Increasingly health care organizations are trying to solve the complicated problem of coordinating patient care among various providers and organizations.
Virtual medical care is an increasingly popular model of health care delivery for the management of common acute illnesses. Virtual visits offer patients convenient and timely access to care, which is especially important when a patient’s condition requires urgent attention. In a piece for the American Journal of Managed Care[26], Priyam Vora discusses findings from a HCFO-funded study from R.
Asheville’s Sona Pharmacy and Clinic recently joined the retail clinic movement, combining a community pharmacy, urgent care, and primary care services under one roof. As Emily Patrick of the Citizen-Times[29] discusses, Sona’s goal is to steer patients away from high-cost care centers by offering available, affordable and comprehensive care at retail clinics.
Primary care has become a focal point of efforts aimed at improving health outcomes and reducing costs in the health care system. However, the shortage of primary care providers is expected to grow significantly in the coming years.