AMA Report Details Low Competition in PBM Market
The American Medical Association released a new report on Monday on pharmacy benefit managers. It explained that there is low competition among PBMs and high vertical integration with payers.
‘Great on Paper’: Why Primary Care Physicians Are Reluctant To Join Value-Based Care
Many primary care physicians are not participating in value-based payment models. A new study details why and potential solutions.
The Funding Model for Cancer Innovation is Broken — We Can Fix It
Closing cancer health equity gaps require medical breakthroughs made possible by new funding approaches.
Why Industry Groups Are Decrying CMS’ Physician Fee Schedule Proposal
CMS issued its proposed rule for next year’s Medicare physician fee schedule, revealing plans to cut payment rates by 2.8%. Industry groups swiftly expressed their outrage, arguing that reimbursement rates need to keep up with the pace of inflation.
Healthcare Moves: A Monthly Summary of Hires and Layoffs
Here is a selection of recent executive hires, promotions and layoffs occurring across the healthcare industry.
How Healthcare Leaders Are Reacting to the Supreme Court Preserving Abortion Pill Access
The Supreme Court sided with the FDA and unanimously ruled to uphold access to abortion pill mifepristone. The decision quells worries about what it might look like if the Supreme Court sided with the physician group — many healthcare leaders feared that if the top court could overturn mifepristone’s FDA approval, the same could happen to other drugs.
Health2047 CEO: As Tech Advances, the Power of Community Engagement Can’t Be Forgotten
In an interview last week, Larry Cohen — CEO of Health 2047, the American Medical Association’s venture studio — noted that digital health programs have proven to do a good job of improving patient outcomes — but only for certain groups. As technology continues to advance, he urged healthcare leaders not to underestimate the effectiveness of engaging patients by having boots on the ground.
Health Executives on Digital Transformation in Healthcare
Hear executives from Quantum Health, Surescripts, EY, Clinical Architecture and Personify Health share their views on digital transformation in healthcare.
AMA President: Medicare Physician Pay Cuts Will Have ‘Dire’ Impact if Not Reversed
The Medicare physician pay cuts that went into effect January 1 is a "disaster for the profession," said Dr. Jesse Ehrenfeld, president of the AMA, during an interview at CES 2024. Getting the pay cut reversed is a top priority for the organization.
How to Ensure Health Equity Isn’t Just a Buzzword
Some healthcare organizations have reduced health equity to a buzzword, using the phrase superficially without a true commitment to dismantling systemic barriers. During a webinar, two industry leaders — AMA President Jesse Ehrenfeld and Emory Healthcare Chief Transformation Officer Amaka Eneanya — discussed why this approach must be avoided and explored how leaders can do better.
What Do Physicians Really Think of AI?
Nearly half of physicians are equally excited and concerned about the use of AI in their field, according to a new AMA survey. Those who felt optimistic about AI cited reduced administrative burden as the number one benefit they’re seeking. Patient privacy and the impact to the patient-physician relationship were the most common reasons physicians cited for having reservations about AI.
Why Provider Groups Are Denouncing CMS’ New Payment Rules
CMS finalized updates to its physician fee schedule for 2024, as well as finalized the rule for next year’s Outpatient Prospective Payment System (OPPS). Provider groups are displeased with the updated rules, arguing that both physicians and provider organizations need more monetary relief than what the agency is offering.
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Market Trends to Watch for Health Systems and Their Specialty Pharmacies
The future looks bright for the integrated specialty pharmacy model – for health systems, providers, and most importantly, for patients.
7 Hot Takes I Heard at HLTH
At HLTH 2023, I had dozens of conversations with providers, digital health investors, startup CEOs and other players in the healthcare industry. When I got home, I compiled seven refreshingly honest takes I heard from them while at the conference.
Why the AMA President Thinks Scope of Practice Expansions Are a ‘Terrible Idea’
To address the growing physician shortage, some people argue that the scope of practice should be expanded for skilled healthcare professionals like nurse practitioners and pharmacists. American Medical Association President Dr. Jesse Ehrenfeld said this is a “terrible idea.” He argued that throwing other professionals into physicians' roles will have poor ramifications of patient safety. In his view, the industry should focus on uplifting strong interprofessional care teams.
Fewer Physicians Are Practice Owners Than Ever & Medicare Rates Are to Blame, AMA Says
Over the past decade, a significant percentage of the country’s physicians have shifted from working in private practices (defined as those owned wholly by physicians) to working in bigger, health system-owned practices. The ability to negotiate higher payment rates with insurers when working at a larger practice is a crucial factor causing this trend, according to a new AMA analysis.
‘This Is Almost Biblical in Its Impact’: Providers Push Back Against CMS’ New Proposed Rules
CMS recently revealed its proposals to raise reimbursement rates for hospital outpatient departments and cut payments for physicians. Next year, the agency is planning to decrease physicians’ pay by 1.25% and increase outpatient payment rates by 2.8%. Provider groups are unhappy with the news — AMA President Dr. Jesse Ehrenfeld said the new physician fee schedule will be “almost biblical in its impact.”
Why Digital Health Startups Should Embrace a Provider-Centric Approach, Per an AMA Exec
Providers often have a checklist of requirements they use to determine whether they should bring new technology into their organization. Digital health startups would be wise to learn about these criteria when taking their products to market, said Meg Barron, the AMA's vice president of digital health strategy, at a recent conference. That way, startups can build their products around meeting providers' needs.