Healthcare Business Week in Review: Insurance Deadline Extension; Specialty Pharmacies; Care Transitions

Tuesday, July 9th, 2013
This post was written by Cheryl Miller

Employers will have more time to comply with the ACA mandate on insurance coverage, according to a White House blog posted by Valerie Jarrett, senior advisor and assistant to the president for Intergovernmental Affairs and Public Engagement.

In response to concern from employers with more than 50 employees working more than 30 hours a week that they would not have enough time to comply with the ruling by 2014, the administration has extended it by a year, and will simplify the reporting process. Plans to open health insurance exchanges on October 1 are still going forward, the administration says. More details can be found inside.

Kidney transplant patients who use specialty pharmacies as opposed to retail pharmacies report lower healthcare costs, according to a study published in the Journal of Managed Care Pharmacy.

The one-year study conducted by Optum found that those transplant patients using individualized services provided by the pharmacies, including adherence and clinical management programs, member education, and counseling services provided by pharmacists trained in transplant pharmacology, showed 30 percent lower post-transplant-related medical costs and 13 percent lower overall healthcare costs.

Medication adherence is one area of transplant medicine that needs improvement, researchers state. While the rate of non-adherence is highest at one to three years post-transplant, it may happen at any point during lifelong therapy.

Personal time and contact with patients during care transitions — before and after their hospital discharge — significantly reduces readmission rates, according to a study conducted by the Bronx Collaborative, a group of hospitals and health insurers in the Bronx, N.Y.

Among 500 patients who received two or more of four interventions by nurse care transition managers in a special program to manage the transition between hospital and home, only 17.6 percent were readmitted to the hospital within 60 days of discharge versus 26.3 percent among a comparison group of 190 patients who received the current standard of care, the data showed.

Another 85 patients who received only one intervention for a variety of reasons had an overall readmission rate of 22.8 percent. More inside on the four interventions.

And, if you have the time, please take our latest 10 question survey on Managing the Dually Eligible. Tell us how you’re managing this population, which constitutes about 9 million individuals who are eligible for both Medicaid and Medicare in the United States, and receive a free executive summary of the compiled results. Your responses will be kept strictly confidential.

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