West Health’s Post

Congressional Health Spending Deal: A Status Quo for Hospitals and PBMs, Raising Concerns About Patient Costs The recent congressional spending deal with health policy attachments has left hospitals and pharmacy benefit managers largely untouched, maintaining the status quo for these powerful industries. However, this could potentially expose patients to higher health costs. With attention shifting to PBMs and hospitals, reforms aimed at transparency and cost control faced significant industry opposition, hindering major changes. Read more about the implications of this deal and the challenges ahead in healthcare policy. #HealthcarePolicy #CongressionalDeal #PatientCosts

Recently, Lockton published a medical and pharmacy trends guide to address the hot topic of rising healthcare costs and what we can expect as we prepare for 2025. Some of the factors contributing to 2025 trend projections include: 1. Inflation 2. Contract negotiations with providers 3. Legislative changes 4. Court cases on fiduciary responsibilities 5. & advancements in pharmacy   While trends continue to rise, there are many strategies employers can take to mitigate the impact to their health plans. Lets connect to see what can be done to help you combat cost increases. 

The enduring demand for GLP-1s is transforming healthcare delivery and pharmacy costs. How can brokers and employers effectively navigate this landscape? Our recent blog features insights from Dr. Avantika Waring, CMO at 9amHealth, and Alissa Johnson, Clinical Strategy Director at SmithRx. These experts explore GLP-1 effectiveness, cost implications, and coverage optimization strategies. The knowledge needed to guide plan sponsors in balancing employee health benefits with financial considerations is right here 🔗 https://lnkd.in/gDPCyyA2 #brokerinsights #healthcare #employeehealth #GLP1 #PBMs

Ever wonder why American healthcare comes with such a hefty price tag? The Commonwealth Fund's study, "High U.S. Health Care Spending: Where Is It All Going?" reveals some startling truths. As compared to patients in other developed countries, American patients paid more for: ✔️ Administrative costs of insurance – 15% of excess spending ✔️ Administrative costs borne by physicians and other providers – 15% ✔️ Prescription drug costs – 10% ✔️ Wages for physicians – 10% ✔️ Wages for nurses – 5% ✔️ Medical machinery and equipment – Less than 5% It is estimated that removing the excess administrative costs could generate significant savings of approximately $276 billion annually! While the U.S. healthcare system offers advanced diagnostics and treatments, it's essential to scrutinize why it comes at such a premium. So, how can we make American healthcare more cost-effective and accessible? Share your insights and ideas in the comments! #HealthcareCosts #USHealthcare #HealthcareSpending #CostReduction

Earlier this year, the HPRI Team and AMS (Advanced Medical Strategies) recently surveyed some of the leading health plans working within payment integrity to understand the several critical points for payers in the healthcare sector as they navigate the complexities and opportunities of 2024. Listen to this summary of the report here or download it here: https://hubs.ly/Q02Lz9JN0 #paymentintegrity #stateofunion #healthcare #pi #fwa

Unlock the door to affordable healthcare. Prescription Hope offers a path to access vital medications at just $60/month per medication. Explore our services on our website: www.PrescriptionHope.com #PrescriptionHope #RX #Help #AffordableMedication #Medication #MedicationAccess #Prescription #PrescriptionAssistance #HCP #Health #Healthcare #HealthServices #FDAApproved #AffordableMedication #PrescriptionDelivery #MedicationAssistance #AffordableHealthcare #HealthcareProfessional #PatientCare #HealthExperts #PatientSafety #HealthTip #WellnessTip #B2B #Marketing #Management #Innovation #Technology #Future #SocialNetworking #PrescriptionProgram #MedicationProgram #Economy #PAP #PatientAssistance #PatientPrograms

Your health, your right. Prescription Hope believes in accessible medications for all. Learn more on our website: www.PrescriptionHope.com #PrescriptionHope #2024 #2024Goals #NewYear #Medication #MedicationAccess #Prescription #PrescriptionAssistance #HCP #Health #Healthcare #HealthServices #FDAApproved #AffordableMedication #PrescriptionDelivery #MedicationAssistance #AffordableHealthcare #HealthcareProfessional #PatientCare #HealthExperts #PatientSafety #HealthTip #WellnessTip #B2B #Marketing #Management #Innovation #Technology #Future #SocialNetworking #PrescriptionProgram #MedicationProgram #Economy #PAP #PatientAssistance #PatientPrograms

In the fifth and final article of his FMV series, Ronnen Isakov explores amendments to the Stark Law and their impact on group practices. Check it out here: https://lnkd.in/gy96XGQW #starklaw #fairmarketvalue #FMV #healthcare #healthcareleaders #healthcaremanagement

Bulk Billing: A Flawed Metric in Disguise? A Doctor's Perspective Lets look into the murky waters of healthcare metrics, specifically the often-touted bulk billing rate in Australia. While it seemingly reflects accessible healthcare, could we be facing a classic case of Goodhart's Law? Goodhart's Law, a cautionary tale for policymakers, states that a measure can cease to be a good measure once it becomes a target. In our case, the focus on increasing bulk billing rates might inadvertently distort and undermine the quality and comprehensiveness of care we, as GPs, strive to deliver. Imagine prioritising bulk billing numbers over a thorough consultation – hardly the recipe for optimal patient outcomes. Further complicating matters are "zombie statistics." These are outdated or misleading figures that lurch on, cited without proper context or verification. Who compiles these bulk billing statistics? Are they designed to paint a rosy picture for political gain, or do they reflect the realities we face in our practices? We need to be critical consumers of data. Focusing solely on bulk billing rates as the holy grail of accessible healthcare incentivises a tick-box mentality. Are we at risk of churning through patients with cursory consultations, neglecting the holistic approach that defines good general practice? Goodhart's Law rears its head again – a well-intentioned metric like bulk billing can morph into a system prioritising quantity over quality. So, how do we move beyond this flawed metric? Let's shift our focus towards meaningful metrics – patient outcomes and satisfaction. Are patients receiving the comprehensive care they need, and are they happy with the quality of service? These are the metrics that truly matter to us as doctors. It's time to move beyond the bulk billing targets and advocate for a system that empowers GPs to deliver high-quality, patient-centred care. #Generalpracticeaustralia #bulkbilling #GPAustralia #healthcarepolicy #GP

We are concerned about regulations and decisions being controlled and enforced by non-experts. The reason for allowing agencies to create rules independently of lawmakers is because of their expertise. Healthcare must brace for the ramifications of a post-Chevron world with weaker (or more cautious) regulators. "Health policy leaders say patients, providers, and health systems should brace for more uncertainty and less stability in the health care system. Even routine government functions such as deciding the rate to pay doctors for treating Medicare beneficiaries could become embroiled in long legal battles that disrupt patient care or strain providers to adapt." What do you think?