CER Daily Newsfeed

Access to Fair Prescription Plans Can Make Employees Healthier

(8/14, Bruce Sherman, Brian Sils, Kimberly Westrich, Benefits Pro) comments “...Improving the management of chronic conditions can help organizations manage their health benefits expenditures. This is particularly true for conditions including diabetes, hypertension, and high cholesterol. Poorly managed conditions are associated with a greater risk of complications, including heart and vascular disease, as well as stroke and kidney disease. An equitable approach to prescription medication use — or pharmacoequity — can help minimize the risk of these complications, resulting in likely improvements in both employee health and business outcomes.” Full

OM1 Expands Neurology Network to Over 3 Million Patients for Real-World Data Research

(8/14, Katie McCool, The Evidence Base) reports “...‘Expanding our neurology network to more than 3 million patients represents a pivotal milestone in enabling better outcomes for neurology patients,’ said Dr Carl Marci, Chief Clinical Officer and Managing Director of Mental Health and Neuroscience at OM1. ‘By integrating deep clinical data and advanced AI, we’re equipping researchers and healthcare providers with powerful tools to uncover new insights into disease progression, treatment response, and more personalized care in complex neurological conditions.’” Full

Video: Optimizing Oncology Care Through Academic–Community Partnerships and Real-World Evidence: Clayton Irvine, PharmD, MBA, MS

(8/13, Clayton Irvine, PharmD, MBA, MS, Alana Hippensteele, MA, The American Journal of Managed Care) “Clayton Irvine, PharmD, MBA, MS, explains that leveraging high-quality, real-world data; cross-institutional collaboration; standardized care pathways; advanced technologies; and integrated academic–community oncology partnerships can improve treatment decision-making, reduce financial toxicity, address drug shortages, and optimize infusion center efficiency.” View Video

CMMI Addresses Some Democratic WISeR Model Worries In FAQ, Comments

(8/13, Christian Robles, Inside Health Policy) reports “...CMS plans to audit WISeR model participants, which will result in reduced payment adjustments for inaccurate determinations, the FAQ says. Model participants with a high inaccuracy rate could be terminated from the model, the FAQ adds. Model participants will pay for processing prior authorization requests and will only be reimbursed once per Medicare beneficiary, the FAQ says. In addition to these safeguards, a source familiar with the WISeR model told Inside Health Policy that CMS’ chief actuary will have to independently evaluate and certify the model before it is expanded. The evaluation would explore whether WISeR improves quality without increasing spending or reduces spending without harming quality, they said.” Subscription Required