Addressing the Drug Cost Challenge; Big Data Combats Rural Health Gaps

March 16, 2021 - Healthcare has faced longstanding challenges with prescription drug costs, health inequities, and care fragmentation. Organizations from across the care continuum are now leveraging capabilities, such as big data, care coordination, and telehealth, to address the major barriers to high-quality, affordable care for all patients.

CVS Addresses Drug Affordability, Access

As one of the largest pharmacy benefit managers, CVS Caremark understands the problems consumers face with drug affordability and access.

“Our clients hire us to ensure that they get appropriate value for the dollars they’re spending on drugs. We're within three miles of 81 percent of the population, which gives us a really interesting ability and connection to the communities to meet that very clearly articulated need from patients,” Alan M. Lotvin, MD, executive vice president of CVS Health and president of CVS Caremark, recently said in an interview with PharmaNewsIntelligence. 

Making sure consumers are prescribed the right medications, crafting robust formularies, and considering alternative drugs (e.g., generics and over-the-counter medications) are three key ways the organization ensures medication adherence in face of affordability and access barriers. READ MORE

Big Data Seeks to Bridge Rural Health Gaps

A new big data initiative is seeking to address critical gaps in knowledge about heart and lung disorders in rural counties, which already display problems with geographic isolation, limited access to healthcare, and higher rates of poverty—all factors that contribute to worse health outcomes.

“This is a large epidemiological study examining 4,600 people over six years. Rural access to care is always an issue, and our goal is to try to understand these problems,” Peter Durda, PhD, Faculty Scientist at the Larner College of Medicine at the University of Vermont and co-investigator of the study, told HealthITAnalytics. “By understanding the health issues these individuals have, perhaps we can help encourage those agencies responsible for healthcare to provide increased access in rural areas.” READ MORE

Medicare Nearly Doubles Rates for COVID-19 Vaccines

CMS has announced new Medicare reimbursement rates for COVID-19 vaccinations. The rates have increased from approximately $28 to $40 for the administration of single-dose vaccines and from approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses.

The higher reimbursement rate aims to “support important actions taken by providers that are designed to increase the number of vaccines they can furnish each day, including establishing new or growing existing vaccination sites, conducting patient outreach and education, and hiring additional staff,” CMS said in the email. READ MORE

Leapfrog Adds Health Equity Questions to Hospital Surveys

As health equity takes center stage, Leapfrog has embedded targeted questions in hospital surveys to measure the impact it has had on healthcare and identify ways to address the patient safety and care quality issue.

“We had to recognize, for us as an organization, what we can do to contribute to the improvement and finally achieving health equity in this country,” Leah Binder, president and CEO of patient safety rankings organization The Leapfrog Group, recently told PatientEngagementHIT.

Including health equity questions is the first step the organization is taking in 2021, followed by stratifying hospitals based on quality and safety data according to race, ethnicity, and language, as well as LGBTQ status.

“We want to understand whether they understand where the gaps might be in the care they're delivering,” Binder stated. READ MORE

Will Telehealth Coverage Be Limited Post-Pandemic?

The Medicare Payment Advisory Commission (MedPAC) is taking a cautious approach to long-term telehealth policy, recommending to Congress that it extend some emergency flexibilities for a few years after the COVID-19 pandemic to gather more evidence about the services.

Specifically, the group wants to know more about telehealth impacts beneficiary access to care, quality of care, and program spending before suggesting permanent policy changes. READ MORE

Clinicians Not Engaging with Genomic Data in EHR

A recent Journal of the American Medical Informatics Association Open study found that clinicians viewed just 1 percent of patient genomic data in the EHR, begging the question about precision medicine implementation.

Specialists were less likely to open genetic study results in the EHR compared to internal medicine clinicians. Genetic study results were also viewed more often around the time of a scheduled patient visit and during a hospitalization compared to an outpatient visit. READ MORE

Building an Integrated Dual Eligible Program

Eligibility, beneficiary protections and enrollment, benefits, delivery system and care coordination, administration, and financing are all key considerations for creating a dual-eligible program that truly integrates Medicare and Medicaid services for proper patient navigation, according to the Medicaid and CHIP Payment and Access Commission (MACPAC).

Without such a program, dual-eligible beneficiaries are at risk for poorer outcomes as a result of fragmented care, the group recently told Congress. READ MORE