PCP Stability In Doubt
Elation Health finds that over 80% of primary care physicians (PCPs) are concerned about financial stability over the next several years. The company surveyed 280 PCPs from Jan. 31 to Feb. Fifty-two percent of respondents were fully independent and 48% have some affiliation.
About 64% cite government and commercial payer reimbursement as their top concern. Staffing costs, workforce challenges, technology and IT costs and rising operational costs are also challenges.
Despite all this, 93% of respondents report remaining committed to primary care. Only 2% report planning to leave the practice.
#providers #physicians #margins
Employer Affordability Challenges
Purchaser Business Group on Health finds that more and more employers are considering switching insurance or pharmacy benefits managers (PBMs) as a result of rising costs. About 37% of members have issued request for proposals (RFP) for medical benefits, meaning they’re shopping between insurance providers. About 23% are conducting an RFP for their pharmacy benefits. About 27% are using non-traditional or transparent PBMs.
In other news, in comments on a proposed Department of Labor rule, employers, lawmakers, patient advocates, price transparency groups and others have urged the agency to quickly finalize a rule that would force PBMs to share more pricing and compensation information and increase reporting and transparency. The PBMs oppose the rule.
Additional articles: https://www.healthcaredive.com/news/employer-health-costs-switch-vendors-pbgh/817551/ and https://www.fiercehealthcare.com/payers/affordability-transparency-look-large-employers-top-healthcare-concerns
#employercoverage #healthcare #affordability
https://www.healthcaredive.com/news/labor-department-pbm-transparency-rule-comments/817794
Cuban Urges Self-Manufacturing
Mark Cuban says he has saved health systems millions by partnering with them through his Cost Plus Drugs initiative. Now he says hospitals can manufacture their own drugs by deploying a modular manufacturing pod on their campuses. He says this would address supply issues for many scarce drugs and lower costs for expensive ones dramatically.
#drugpricing #hospitals #cuban
Additional article: https://www.beckershospitalreview.com/pharmacy/mark-cuban-wants-to-bring-drug-manufacturing-to-hospitals-doorsteps-literally/
Joint Replacement Model Expanded
The Centers for Medicare and Medicaid Services (CMS) will broaden a traditional Medicare joint replacement bundled payment model that has saved more than $100 million. A draft rule says the agency wants to expand the decade-old Comprehensive Care for Joint Replacement Model, dubbed CJR-X, beginning Oct. 1, 2027. It would be made a mandatory nationwide demonstration. Rates, quality measures, and risk adjustment would all be updated.
#medicare #innovation #vbc #vbp
https://www.modernhealthcare.com/politics-regulation/mh-cms-cjr-x-model-joint-replacement
— Marc S. Ryan
