Stats & Data

Comment open on leading healthcare value pricing methodology

The Institute for Clinical and Economic Review (ICER) is seeking public input on their methodology to their development of benchmark prices for tests, treatments, drugs and innovations based on their value. ICER, an independent non-profit research institute, is the key source for value-based assessments. Their reports are used by the VA, Medicare, Medicaid, commercial plans…

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For the Book Club: The Tyranny of Metrics

As the world moves toward data and analytics to evaluate progress (and it should), we need to be careful that the movement is meaningful. This must-read is full of cautionary tales, including a chapter on medicine, of mis-use of metrics to evaluate performance that ended up doing more harm than good and box-checking in place…

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What We’re Reading

Pharma lobbyists flooded Maryland to block a drug-pricing bill. Opponents pushed back – and won. STAT – The story behind the story of how a group of consumer advocates and legislators were able to prevail over Pharma’s considerable resources to get a bill passed to push back on sky high drug prices and protect consumers…

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Seven years later, Connecticut Medicaid still saving taxpayers money

Download the report As with most health care in Connecticut, Medicaid spending was rising quickly before 2012 growing by almost half over the prior four years. But in 2012, Connecticut made a remarkable and unique move — Medicaid switched from a capitated payment model using private insurers to a care coordination-focused, self-insured payment model. Since…

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Mixed results from great study on Medicaid behavioral health interventions

Yesterday’s MAPOC Complex Care Committee meeting focused on results of an adult high behavioral health need member initiative by Beacon, Medicaid’s behavioral health administrator. The program serves high utilizers of hospital services with behavioral health needs providing intensive care management by teams of clinicians and peer specialists. Medicaid members with high behavioral health needs were…

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Medicaid update: Quality improving but lots of work to do

Friday’s Medicaid Council meeting focused on quality performance in the program. The good news – ED visits and readmissions continue dropping across the program, although community health centers’ performance remains a problem Well-child visit and lead screening rates are higher than the national average Routine care is increasing and inpatient care is decreasing The bad…

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