Subject(s)
Early Detection of Cancer , Neoplasms , Humans , Michigan , Neoplasms/diagnosis , Neoplasms/prevention & controlSubject(s)
Alzheimer Disease/drug therapy , Antibodies, Monoclonal, Humanized/economics , Budgets , Drug Costs , Drug Industry/economics , Insurance Coverage/economics , Medicare/economics , Reimbursement Mechanisms/economics , State Government , Antibodies, Monoclonal, Humanized/therapeutic use , Centers for Medicare and Medicaid Services, U.S. , Humans , Insurance Coverage/legislation & jurisprudence , Medicaid/legislation & jurisprudence , Medicare/legislation & jurisprudence , Reimbursement Mechanisms/legislation & jurisprudence , United StatesSubject(s)
Commerce/legislation & jurisprudence , Cost Savings/legislation & jurisprudence , Drug Costs/legislation & jurisprudence , Health Policy/legislation & jurisprudence , Prescription Drugs/economics , State Government , Canada , Drug Industry/legislation & jurisprudence , Government Regulation , United StatesABSTRACT
The elderly in long-term care (LTC) and their caregiving staff are at elevated risk from COVID-19. Outbreaks in LTC facilities can threaten the health care system. COVID-19 suppression should focus on testing and infection control at LTC facilities. Policies should also be developed to ensure that LTC facilities remain adequately staffed and that infection control protocols are closely followed. Family will not be able to visit LTC facilities, increasing isolation and vulnerability to abuse and neglect. To protect residents and staff, supervision of LTC facilities should remain a priority during the pandemic.
Subject(s)
Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Residential Facilities/organization & administration , Aged , Aging , Betacoronavirus , COVID-19 , Elder Abuse/prevention & control , Elder Abuse/psychology , Family/psychology , Humans , Infection Control/organization & administration , Residential Facilities/standards , Risk Factors , SARS-CoV-2 , Social Isolation/psychologySubject(s)
Drug Industry/legislation & jurisprudence , Fees, Pharmaceutical/legislation & jurisprudence , Formularies as Topic , Government Regulation , Medicaid/legislation & jurisprudence , State Government , Centers for Medicare and Medicaid Services, U.S. , Drug Approval/legislation & jurisprudence , Drug Costs , Insurance Coverage , Massachusetts , United States , United States Food and Drug AdministrationSubject(s)
Centers for Medicare and Medicaid Services, U.S./legislation & jurisprudence , Government Regulation , Health Care Reform/legislation & jurisprudence , Health Services Research/legislation & jurisprudence , Reimbursement Mechanisms/legislation & jurisprudence , Medicaid/economics , Medicaid/legislation & jurisprudence , Medicare/economics , Medicare/legislation & jurisprudence , Patient Protection and Affordable Care Act , United States , United States Dept. of Health and Human ServicesABSTRACT
In recent years, drug manufacturers and private payers have expressed interest in novel pricing models that more closely link a drug's price to its value. Indication-based pricing, outcome-based pricing, drug licenses, and drug mortgages have all been discussed as alternatives to paying strictly for volume. Manufacturers and payers have complained, however, that Medicaid's "best-price rule" inhibits their ability to enter into these new pricing arrangements. This article examines the best-price rule and assesses to what extent, if any, it might frustrate the goal of paying for value. We conclude that the best-price rule is not as serious a problem as it is sometimes made out to be but that it is also not simply a convenient excuse for refusing to try something new. The law here is complex, and moving to a pay-for-value model for drugs will require close coordination among manufacturers, payers, and regulators.
Subject(s)
Delivery of Health Care/economics , Prescription Drugs/economics , Drug Costs , Drug Industry/economics , Drug Industry/legislation & jurisprudence , Humans , Medicaid/economics , United StatesSubject(s)
Insurance Coverage/legislation & jurisprudence , Medicaid/legislation & jurisprudence , Patient Protection and Affordable Care Act , State Health Plans , Medicaid/organization & administration , Patient Protection and Affordable Care Act/legislation & jurisprudence , State Government , United StatesSubject(s)
Cost Sharing/legislation & jurisprudence , Financing, Government/legislation & jurisprudence , Patient Protection and Affordable Care Act/legislation & jurisprudence , Politics , Health Care Reform/legislation & jurisprudence , Humans , Insurance Coverage/legislation & jurisprudence , United StatesABSTRACT
The debate over how to tame private medical spending tends to pit advocates of government-provided insurance--a single-payer scheme--against those who would prefer to harness market forces to hold down costs. When it is mentioned at all, the possibility of regulating the medical industry as a public utility is brusquely dismissed as anathema to the American regulatory tradition. This dismissiveness, however, rests on a failure to appreciate just how deeply the public utility model shaped health law in the twentieth century-- and how it continues to shape health law today. Closer economic regulation of the medical industry may or may not be prudent, but it is by no means incompatible with our governing institutions and political culture. Indeed, the durability of such regulation suggests that the modern embrace of market-based approaches in the medical industry may be more ephemeral than it seems.
