I tell my patients there are three types of science: 1) investigative science, which sometimes gets it right; 2) science in the courtroom, which is junk science; and 3) science in Washington, D.C., which is political science. Our decisions are based on art and science; our patients’ medications are brought to market based on science….
After years of speculation about potential cost savings and debates on safety, biosimilars are about to step onto the stage of rheumatic disease treatment. On Feb. 9, the Arthritis Advisory Committee of the U.S. Food and Drug Administration (FDA) met in Washington, D.C., and recommended the approval of CT-P13, a proposed biosimilar to infliximab (Remicade),…
Transitions in medical care can be high-risk periods due to the loss of continuity in care and worsening of medical conditions. Approximately one-quarter of the estimated 18 million adolescents aged 18–21 years in the U.S. have chronic conditions, including rheumatic diseases. Interventions in rheumatology practice can improve transition processes. Transition-readiness assessment tools and transition-satisfaction scales are available for use in rheumatology transition processes…
(Reuters Health)—Mind-based therapy programs may help ease chronic back pain, new research suggests. Patients who took part in such programs were more likely to have noticeable and lasting improvements in back pain than those who stuck to their usual routines, investigators found. Both of the approaches tested in the study—mindfulness-based stress reduction (MBSR) and cognitive…
Both government and private payers continue to aggressively monitor providers to prevent and recover overpayments. This is evidenced by the fact that the number of audits conducted in recent years has increased dramatically. A negative audit finding can result in the need to repay five- or seven-figure amounts. Types of Audits Private Payer Audits Private…
Value is the ratio of quality to cost. The delivery and measurement of healthcare quality, however, is complex. “We first need to understand and define the health outcomes that are important to patients. Then we need to put into place care pathways that will lead to those outcomes, and finally we need mechanisms to measure…
The care of patients with rheumatic diseases has undergone a great transition, with high expectations for both patients and healthcare professionals to achieve quality outcomes for the many different disorders. Integral to this goal is the development of new care models, with evolving roles for the various care providers on the multidisciplinary team.1-3 A new…
Approximately 10 years ago, the Office of Inspector General (OIG) issued its first guidance on compliance as it relates to federal mandates for physician practices. Although taking the necessary steps can be a daunting task in an era of complex rules and heightened regulations, there are key areas of government-mandated compliance requirements that practices should…
SAN FRANCISCO—Research is revealing more clues about the environmental factors that likely play a role in triggering rheumatoid arthritis (RA) in patients who are susceptible—or that may even protect them from autoimmunity. Large-scale, lengthy population studies conducted at institutions worldwide provide in-depth data from which to identify potential triggers and protective factors for RA, from…
WASHINGTON (Reuters)—Aetna Inc.’s plan to buy smaller insurer Humana Inc. for $31 billion will mean seniors will pay higher Medicare Advantage premiums, according to a new report by the think tank Center for American Progress (CAP). Aetna’s proposed deal for Humana would combine Aetna’s 7% of the Medicare Advantage market with Humana’s 19%, and make…