Soaring Prices Put Drugs out of Reach for Many Americans

Retail prices for more than 100 widely used specialty prescription drugs surged by nearly 11 percent in 2013, according to a new AARP Public Policy Institute (PPI) report issued today. The report found that the average annual cost of a specialty medication used to treat chronic diseases and conditions rose to more than $53,000 — greater than the U.S. median income and more than twice the $23,500 median income of people on Medicare. Specialty-prescription-drug prices are 18 times higher than …

Is Observation Status Substituting for Hospital Readmission?

Since October 2012, the Medicare program has penalized hospitals when too many patients in traditional Medicare are re-hospitalized within a month of discharge. This policy appears to be having unintended consequences for patients in Medicare and in the commercial market. Hospitals with readmission rates above the national average now receive lower payments across-the-board from Medicare; the higher the rate of “excess” readmissions, the greater the penalty. The fines are intended to push hospitals to provide better care for their patients …

Bitten by a Crocodile? There’s a Code for That

A seismic change in Medicare and the rest of the U.S. health care industry began Oct. 1, when a new system of diagnostic codes — which all health providers must use to get paid — finally went into effect after a decade of controversy. The change is making the industry hold its breath, nervous of how it will play out. Will honest mistakes in coding cause claims to be delayed or, worse, go unpaid? Will some physicians, overwhelmed by the …

Good and Bad News About Ovarian Cancer

Two new studies this week have upended some basic assumptions about ovarian cancer, questioning both the survival rate of this dangerous disease and the best type of chemotherapy to improve those survival odds. First, a new study, led by researchers at Dana-Farber/Brigham and Women’s Cancer Center in Boston, found that a potentially lifesaving treatment for those with advanced ovarian cancer is being used on less than half of patients. And second, researchers at the University of California, Davis say that …

Congress Approves Bill Bolstering Medicare Patients’ Hospital Rights

The U.S. Senate unanimously approved legislation Monday night requiring hospitals across the nation to tell Medicare patients when they receive observation care but have not been admitted to the hospital. It’s a distinction that’s easy to miss until patients are hit with big medical bills after a short stay. The vote follows overwhelming approval in the U. S. House of Representatives in March. The legislation is expected to be signed into law by President Barack Obama, said its House sponsor, …

Medicare Itemizes Its $103 Billion Drug Bill

The federal government popped the cap off drug spending on April 30, detailing doctor-by-doctor and drug-by-drug how Medicare and its beneficiaries spent $103 billion on pharmaceuticals in 2013. The data show that 14 drugs cost the federal government and Medicare beneficiaries more than $1 billion each, accounting for nearly a quarter of Medicare prescription drug spending in 2013. Most of those drugs are used to treat chronic conditions that plague the elderly, including diabetes, depression, high cholesterol and blood pressure, …