OBR Daily Commentary

forumImage

Health Plans Must Not Discriminate Against Patients with Cancer, ASCO States in Letter to CMS

(ASCO in Action) Jan 4, 2018 - On December 27, ASCO sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma to reiterate the society’s Principles for Patient-centered Health Care Reform and to weigh in on the proposed notice, “Patient Protection and Affordable Care Act; Health and Human Services (HHS) Notice of Benefit and Payment Parameters for 2019.”

Read Article arrow

Winston Wong, PharmD (Posted: January 10, 2018)

quotes

Prior to the "Benefit Exchange" individual market, most states had regulations stating minimal, but essential, mandatory benefit coverage for individual and small groups. Due to the high risk pools in this population, cost ratios were high. Payers had to attempt to manage benefits to minimize losses. Some were aggressive and survived. so if we look back, the model was in place insuring access to care. What came about with the exchange market was that the mandatory benefits were expanded benefit, resulting in a high actuarial cost. Hence, the market blew up. Maybe we need to step back in time to evaluate bringing back a model that may have come closer to being affordable.

quotes

Reply

Add Comment 1 Comment(s)

Meet the Editorial Board

Prostate Cancer
member photo
Tomasz M. Beer, MD, FACP

Professor of Medicine, Division of Hematology/Medical O...

Community Oncology
member photo
Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
member photo
Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
member photo
H. Jack West, MD

Medical Director, Thoracic Oncology Program, Swedish Ca...

Gastrointestinal Cancers
member photo
Howard S. Hochster, MD

Distinguished Professor of Medicine, Rutgers Robert Woo...

Radiation Oncology
member photo
Howard Sandler, MD, MS, FASTRO

Ronald H. Bloom Chair in Cancer Therapeutics
Pr...

Community Oncology
member photo
Jeff Patton, M.D.

CEO Tennessee Oncology...

Precision Medicine Section Editor
member photo
Jennifer Levin Carter, MD, MPH

Chief Medical Officer and Founder, N-of-One...

Financial Sector
member photo
Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
member photo
Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

Editor-In-Chief
member photo
Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

Health Policy
member photo
Ted Okon

Executive Director Community Oncology Alliance...

Community Oncology
member photo
Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Community Oncology
member photo
William Harwin MD

Florida Cancer Specialists President and Managing Part...

Health Policy
member photo
William McGivney, PhD

National Health Policy Expert...

Payer
member photo
Winston Wong, PharmD

President, W-Squared Group...