AHIP: Botox Marked Up 78% in Hospitals Over Pharmacies 

By Staff Reporters

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AHIP: Botox Marked Up 78% in Hospitals Over Pharmacies 

•  Botox markups: 78% in hospitals, 17% in physician offices
 •  Herceptin markups: 131% in hospitals, 40% in physician offices
 •  Keytruda markups: 104% in hospitals, 21% in physician offices
 •  Ocrevus markups: 59% in hospitals, 13% in physician offices
 •  Opdivo markups: 112% in hospitals, 18% in physician offices
 •  Prolia markups: 215% in hospitals, 49% in physician offices
 •  Remicade markups: 124% in hospitals, 15% in physician offices
 •  Rituxan markups: 85% in hospitals, 7% in physician offices
 •  Tecentriq markups: 95% in hospitals, 25% in physician offices
 •  Xolair markups: 76% in hospitals, 16% in physician offices

Notes: Drugs with the highest total spend in 2019, which are also commonly delivered through specialty pharmacies. The drug cost estimate in physician offices and hospitals does not include the cost of administering the drugs.
Source: AHIP, “Hospital Price Hikes: Markups for Drugs Cost Patients Thousands of Dollars,” February 2022

CITE: https://www.r2library.com/Resource/Title/082610254
 

BUSINESS MEDICINE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

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DICTIONARY: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

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FIVE CONDITIONS: Total 50% of Healthcare Financial Costs

By Staff Reporters

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5 Conditions Total 50% of Healthcare Costs

 •  Cancer makes up nearly 15% of all healthcare spending with employers in the study paying $533 million for nearly 103,000 cancer claims.
 •  Musculoskeletal conditions (including joint wear, knee injuries, hip pain, etc.) makes up 13% of healthcare spending with employers spending $477 million for 317,000 musculoskeletal claims.
 •  Cardiovascular conditions (including heart rhythm issues, stroke, heart attack, and heart failure) makes up 9% of healthcare spending with employers paying $357 million towards 169,000 claims.
 •  Gastrointestinal conditions (including colitis, irritable bowel system, celiac disease, etc.) makes up 7% of healthcare spending with employers paying $284 million for 136,000 claims.
 •  Neurological conditions (including Parkinson’s disease, migraines, epilepsy, etc.) makes up 6% of total health care spending with employers paying $225 million for 240,000 claims.

Source: HAC and UHC via ACDIS, April 14, 2022

CITE: https://www.r2library.com/Resource/Title/082610254

HOSPITALS: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

MANAGED CARE: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

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SURVEY: Artificial Intelligence [A.I.] in Health Care

By AMA and MCOL

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JAMA: Public Views About Artificial Intelligence in Health Care

A recent JAMA survey asked “Overall, in the next 5 years, do you think AI will make health care in the United States?” The survey results were as follows:

 •  Much better: 10.9%
 •  Somewhat better: 44.5%
 •  Minimal change: 19.3%
 •  Somewhat worse: 4.3%
 •  Much worse: 1.9%
 •  Don’t know: 19%

Source: JAMA Network, May 4, 2022

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DICTIONARY: https://www.amazon.com/Dictionary-Health-Information-Technology-Security/dp/0826149952/ref=sr_1_5?ie=UTF8&s=books&qid=1254413315&sr=1-5

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AMA: Doctors Committed to Tele-Health

By AMA / MCOL

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AMA: Doctors Committed to Tele-Health

 •  More than 80% said patients have better access to care since using telehealth.
 •  62% believe patients have higher satisfaction since offering telehealth.
 •  60% agreed telehealth enabled them to provide high-quality care.
 •  56% are motivated to increase telehealth use in their practices.
 •  44% indicated that telehealth decreased the costs of care.

Source: AMA, April 1, 2022

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REPORT: Digital Health Technology

By Staff Reporters and MCOL

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Digital Health Tech Report – 5 Key Findings

 •  48% of hospitals don’t have a strong digital health strategy.
 •  90% believe a strong digital health strategy is critical to improving outcomes, increasing productivity, and enhancing clinician satisfaction.
 •  55% receive more than 11 vendor calls and emails from digital health solution vendors per week.
 •  95% say it’s challenging to narrow down the list of digital health solutions to evaluate.
 •  25% are “very confident” that, after selecting a new digital health solution, it’s truly the best one for their unique needs.

Source: Panda Health, April 2022

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SURVEY: On Nurse Caregivers and Unions

By MCOL

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Nurses Survey: The 4 Takeaways

 •  87% of patients or their caregivers feel some level of stigma associated with their or the person in their care’s current health condition.
 •  44% reported feeling embarrassed to talk about their current health condition.
 •  43% felt their health condition isn’t something that’s regularly talked about and is rarely represented in the media.
 •  99% patients and their caregivers say that stigma can negatively impact or slow perceived healing of a patient with a current health condition.

Source: Convatec Group Plc via PRNewswire, May 18, 2022

UNIONS: https://www.msn.com/en-us/health/medical/unions-tempt-nurses-to-change-their-principles/ar-AAY2cUg?li=BBnb7Kz

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SURVEY: Affordable ACA Family Coverage

By MCOL

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Families USA: Uninsured Rate by Quarter •  Q4 2020: 10.3%
 •  Q1 2021: 9.5%
 •  Q2 2021: 9.7%
 •  Q3 2021: 8.9%

Source: Families USA, “ACA’s Promise of Affordable Health Coverage for Families Across America Is at Risk as Pandemic-Era Policies Expire,” March 2022

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Healthcare LOGISTICS Survey

By MCOL

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4 Key Take-Aways

 •  87% of nurses said that medical courier deliveries—or lack thereof—impacted their work weekly.
 •  32% of nurses have created a “secret stash” of supplies.
 •  27% have personally transported an item to another facility in the past year to overcome courier issues.
 •  19% said that errors or delays impacted their ability to provide patient care five or more times per month.

Source: American Nurse Journal via Businesswire

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FRUSTRATED Physicians!

By Staff Reporters

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65% of Physicians Report Feeling Frustrated in Past 3 Months

A recent study by Survey Healthcare Global on the mental health of healthcare professionals found:

 •  65% of physicians report feeling frustrated.
 •  54% of physicians report feeling burned out.
 •  52% of physicians report feeling unappreciated.
 •  Respondents rank constant stress (34%) and staff shortages (30%) as the leading factors for stress.
 •  18% report that they are more likely to drink, smoke, or use/abuse substances as a result.
 •  75% say their organizations do not offer any wellness resources and programs to HCP employees.

Source: Survey Healthcare Global Via Business Wire, March 21, 2022

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ORDER: https://www.routledge.com/Risk-Management-Liability-Insurance-and-Asset-Protection-Strategies-for/Marcinko-Hetico/p/book/9781498725989

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OUTCOMES: In-Person and Tele-Health Encounters During COVID-19

By Staff Reporters and MCOL

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Outcomes of In-Person and Tele-Health Encounters During COVID-19

 •  Ambulatory encounters decreased by 1.0% and the number of in-person encounters per enrollee decreased by 17.0% from 2019 to 2020.
 •  For members with an initial telehealth encounter for a new acute condition, the adjusted odds ratio was 1.44 for all follow-ups combined and 1.11 for an emergency department encounter.
 •  For members with an initial telehealth encounter for a new chronic condition, the adjusted odds ratios were 0.94 for all follow-ups combined and 0.94 for in-patient admissions.

Source: JAMA Network, April 26, 2022

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SURVEY: Employee Financial Healthcare Affordability

By Staff Reporters and MCOL

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WTW: Employee Healthcare Affordability Survey

 •  By the end of 2023, most employers (95%) are expected to offer virtual care for medical and behavioral health issues, and 61% expect to offer lower cost sharing for virtual care.
 •  Over half (55%) think the expansion of virtual care will help decrease costs in the long run, and 50% think it will improve outcomes.
 •  Employer confidence in sponsoring healthcare benefits over the next 10 years is at its highest point in over 10 years (84% in 2022 versus 38% in 2011).
 •  One in 10 employers (9%) currently offer genetic testing as a screening for early-stage cancer with another 5% planning to do so by 2023.

Source: Willis Towers Watson, April 26, 2022

CITE: https://www.r2library.com/Resource/Title/082610254

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ACCOUNTABLE CARE: Competitive Market for Talent is Biggest Challenge in Recruiting

By Staff Reporters

DEFINITION: An accountable care organization (ACO) is a group of doctors, hospitals, and other health care providers that work together on your care. Their goal is to give you — and other people on Medicare — better, more coordinated treatment. The largest effort in payment innovation in Medicare is a portfolio of accountable care organization (ACO) programs that include the Medicare Shared Savings Program (MSSP), the Next Generation model, and Comprehensive End Stage Renal Disease model. But drawbacks include limited choice as some patients will have trouble finding doctors outside of a specific group. The shortage of options could lead to higher patient costs. And, referral restrictions as ACOs provide doctors incentives to refer to specialists within the group.

CITE: https://www.r2library.com/Resource/Title/082610254

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In a recent survey from AKASA healthcare finance leaders ranked the biggest challenges in recruiting and retention within the revenue cycle as healthcare organizations navigate significant staffing gaps across the board.

Great Resignation: https://medicalexecutivepost.com/2022/03/08/healthcare-industry-hit-with-the-great-resignation-retirement/

 •  #1: Competitive market for talent (71%)
 •  #2: Vaccine mandates (42%)
 •  #3: Employee burnout (41%)
 •  #4: Rapid employee turnover (40%)
 •  #5: Limitations to offer remote work (23%)

Source: AKASA via PR Newswire, February 23, 2022

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45% of Hospitals Have a Shortage of Primary Care Physicians

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By Staff Reporters

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A recent American College of Healthcare Executives’ survey of 310 hospital CEOs shows:

 •  94% have personnel shortages in registered nursing field
 •  85% have personnel shortages in technicians field
 •  67% have personnel shortages in therapists field
 •  45% have personnel shortages in primary care physicians field
 •  43% have personnel shortages in physician specialists field
 •  31% have personnel shortages in physician extenders and specially certified nurses field

Source: American College of Healthcare Executives, “Top Issues Confronting Hospitals in 2021, February 4, 2022

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56% of Patients Attempted to Stretch Out a Prescription

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By Staff Reporters

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56% of Patients Attempted to Stretch Out a Prescription According tot a Recent CoverMyMeds Survey of 1,000 patients. It found: 

•  79% of patients said they’ve gone to the pharmacy only to discover a prescription cost more than they expected.
•  When faced with an affordability challenge, 56% of patients attempted to stretch out a prescription.
 •  When faced with an affordability challenge, 52% of patients skipped bills or other essential items to afford medications.
•  When faced with an affordability challenge, 51% of patients sacrificed medications to pay bills and other essentials.

Source: CoverMyMeds, “2022 Medication Access Data Guide,” February 2022

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CITE: https://www.r2library.com/Resource/Title/0826102549

Rx Podcast: https://medicalexecutivepost.com/2022/02/20/podcast-how-to-write-a-medical-prescription-rx/

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H2 Healthcare Data Breach Report

MCOL Cyber Attacks

By Staff Reporters

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Critical Insight: 2021 with 5 Findings

 •  In 2021, 45 million individuals were affected by healthcare cyber-attacks, up from 34 million in 2020.
 •  The total number of affected increased 32% over 2020, meaning that more records are exposed per breach each year.
 •  Breaches only rose 2.4% from 663 in 2020 to 679 in 2021 but still hit historic highs.
 •  Hacking/IT incidents continue as the most common cause of breaches with an increase of 10% in 2021.
 •  Hacking incidents at outpatient/specialty clinics saw a 41% increase in these types of breaches in 2021.

Source: Critical Insight via Fierce Healthcare, February 1, 2022

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Hospital Revenue Cycle Recruitment Survey

By Staff Reporters

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Entry-level Revenue Cycle Recruitment Takes 84 Days on Average

A recent AKASA survey of 514 chief financial officers and revenue cycle leaders at hospitals and health systems in the U.S. found:

 •  Entry-level revenue cycle talent (0-5 years): On average, costs $2,167 for recruitment and takes 84 days to fill vacant roles.
 •  Mid-level revenue cycle talent (6-10 years): On average, costs $3,581 for recruitment and takes 153 days to fill vacant roles.
 •  Senior-level revenue cycle talent (10+ years): On average, costs $5,699 for recruitment and takes 207 days to fill vacant roles.

Source: AKASA via PR Newswire, “Survey: Recruitment Costs, Long Hiring Timelines Negatively Impact Healthcare Finance Teams”, January 26, 2022

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Average Annual Healthcare Growth Rates of Spending, Utilization and Price

By Staff Reporters

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Average Annual Growth Rates of Spending, Utilization, and Prices

 •  Spending per person: commercial insurers (3.2% per year); Medicare fee for service (1.8% per year)
 •  Utilization per person: commercial insurers (0.4% per year); Medicare fee for service (0.5% per year)
 •  Prices paid to providers: commercial insurers (2.7% per year); Medicare fee for service (1.3% per year).

Notes: For hospitals and physicians’ services, 2013-2018
Source: Congressional Budget Office – January 2022

“The Prices That Commercial Health Insurers and Medicare Pay for Hospitals’ and Physicians’ Services”
 

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CMS: MSSP ACO Growth 2012-2022

By Staff Reporters

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DEFINITION: An accountable care organization is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation.

CITE: https://www.r2library.com/Resource/Title/0826102549

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See the source image

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CMS MSSP ACO Growth 2012-2022

Performance YearACOsAssigned Beneficiaries
202248311.0 million
202147710.7 million
202051711.2 million
201948710.4 million
201856110.5 million
20174809.0 million
20164337.7 million
20154047.3 million
20143384.9 million
2012+20132203.2 million

Source: CMS 2022 Shared Savings Program Fast Facts – As of January 1, 202

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PODCAST: First Quarter 2021 Health Plan Financial Results

THE SHERLOCK COMPANY

This podcast features a brief discussion by colleague Doug B. Sherlock CFA, Senior Health Care Analyst and President, Sherlock Company http://www.sherlockco.com featuring his insights into the quarterly financial reports of health plans, for the first quarter 2021.

The Sherlock Company | LinkedIn

PODCAST: https://www.healthsharetv.com/content/first-quarter-2021-health-plan-financial-results-podcast

Your thoughts are appreciated.

Citation: https://www.r2library.com/Resource/Title/0826102549

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PROCEDURES: Rural v. Urban Hospitals

Appreciating the Number of Procedures Done per Hospitalization

By http://www.MCOL.com

JOURNAL RURAL HEALTH: Rural hospitals are not associated with worse postoperative outcomes for colon cancer surgery: https://onlinelibrary.wiley.com/doi/full/10.1111/jrh.12596

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Hospitals

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ASSESSMENT: Your thoughts are appreciated.

INVITE DR. MARCINKO: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

order textbook: https://www.amazon.com/Financial-Management-Strategies-Healthcare-Organizations/dp/1466558733/ref=sr_1_3?ie=UTF8&qid=1380743521&sr=8-3&keywords=david+marcinko

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Monthly Percentage Change in Health Care Utilization

By Specialty – CIRCA 2019-2020

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Barrierers to Healthcare

For U.S .Women

By http://www.MCOL.com

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Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Contact: MarcinkoAdvisors@msn.com

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