December 2014

After months of delay, the Medicare Administrative Contractor (MAC), with jurisdiction over most molecular diagnostic tests used to treat cancer, made a series of decisions this fall that will allow Medicare reimbursement for several well-known tests, including 3 used in the treatment of prostate cancer.

With the FDA approval of several oral chemotherapy agents, the cost of medications to treat cancer is increasing rapidly. To control costs, legislators, patient advocates, and physicians have pushed for oral chemotherapy parity laws.

Sweeping changes to the way America delivers care at the end of life would better serve patients and their families, while achieving the goals sought in the Affordable Care Act (ACA) of better health, cost savings, and especially patient satisfaction

It is always fun to try to predict the future. Invariably you will be wrong.

Several initiatives that have a dramatic impact on healthcare today were born during that time–managed care, transitioning away from inpatient care toward outpatient care, and the introduction of clinical pathways.

Faced with steep regulations, slashed reimbursement rates, and a shift in focus from fee-for-service (FFS) to delivering value, insurers and physician groups are experimenting with new forms of payment incentives.