The pharmaceutical industry, insurers and the Obama administration all want prescription drugs to be included in determinations about whether a certain pools of patients are riskier than others.
The determinations are important because insurers who take on riskier sets of patients are eligible to receive compensation under Obamacare. Right now, those determinations are made using just medical claims.
Drug companies and insurers generally agree that prescription drugs should be included in the risk adjustment models. They currently are not.
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Obamacare to date has failed miserably relative to what was originally promised regarding how many people would get covered and the number of these who would obtain their coverage through the Obamacare exchanges.
The president’s claim that “America is on a stronger footing because of the Affordable Care Act” is dubious at best. Literally no major promise made for this law has been kept and some have been broken quite egregiously.
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The Medicare Advantage Value-Based Insurance Design Model kicks off Jan. 1, 2017 and will run for five years.
Value-based insurance design, or VBID, refers to health plans that waive or lower out-of-pocket costs for healthcare and prescription drugs that are proven effective for patients with chronic health conditions.
The CMS wants feedback on ways to promote quality of care and reduce cost of care for enrollees in the Medicare Advantage program.
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Most of the remaining non-elderly uninsured people in the U.S. likely won’t gain coverage, a new study released this week suggests.
The study, from the Urban Institute says that while some higher-income people who are uninsured will surely gain coverage as the penalties for not having insurance increase, the possibility for increased coverage is actually lower among those who have higher incomes than those who are eligible for financial assistance to cover insurance.
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