Results for: healthcare costs

The Danish Medicines Agency has implemented a new policy favoring less expensive medications for type 2 diabetes patients, potentially impacting the prescription of popular GLP-1 drugs such as Novo Nordisk’s Ozempic. The agency’s decision aims to reduce healthcare costs and promote the use of equally effective alternatives to GLP-1 drugs. The move has drawn attention amidst concerns about the rising prices of GLP-1 drugs like Ozempic and their increasing use for weight loss purposes, leading to shortages in some countries.

To curb soaring healthcare expenses, California has imposed a 3% annual cap on price hikes by doctors, hospitals, and health insurance companies, effective 2029. The Health Care Affordability Board approved this measure to combat California’s 5.4% healthcare cost increase over the past two decades, which outpaced income growth. The cap will be phased in over five years and enforced by the Office of Health Care Affordability, with potential fines for non-compliance. Despite support from the healthcare industry for a cost target, they argue the 3% cap is unsustainable, citing rising expenses like worker salaries and a new $25 minimum wage for healthcare workers.

In a bid to curb rising medical costs, the California Health Care Affordability Board has approved a 3% annual price increase cap for doctors, hospitals, and healthcare providers in the state, starting in 2029. This cap aims to address the escalating costs of healthcare in California, which have been rising at a rate of 5.4% per year for the past two decades. The cap will be implemented gradually over five years, with a 3.5% increase in 2025. A new state agency, the Office of Health Care Affordability, will be responsible for enforcing the rule, and providers who fail to comply could face fines.

North Carolina is facing financial strain due to the high cost of popular weight loss drugs, prompting the state to stop providing coverage and negotiate directly with manufacturers. Negotiations are ongoing, but patients are concerned about the impact on their health and access to medication.

Spending on GLP-1 drugs, including Ozempic and Wegovy, has skyrocketed in recent years, putting a strain on the U.S. healthcare system and the federal government. The American Society of Health-System Pharmacists reports that GLP-1 treatments were a major factor in last year’s rise in overall drug expenses for entities like pharmacies and hospitals. The approval of Wegovy for preventing cardiovascular complications could further increase Medicare spending by $2.8 billion annually.

A newly introduced bill in the U.S. House aims to increase Social Security benefits for seniors by adjusting the formula used to determine the yearly cost-of-living-adjustment (COLA). Rep. Ruben Gallego’s Boosting Benefits and COLAs for Seniors Act proposes using the Consumer Price Index for Americans aged 62 or older (CPI-E) to calculate COLA, which considers medical expenses more heavily than the current CPI-W index. This change could potentially lead to higher benefits for seniors, as healthcare costs often disproportionately impact their expenses. The bill also mandates the Bureau of Labor Statistics to calculate and publish the CPI-E monthly.

Penstock Group, a leader in healthcare payment integrity, has partnered with Paradigm, an accountable specialty care management organization, to integrate Paradigm’s expertise in surgical implant claim accuracy into Penstock’s programs. The partnership will leverage ClearBridge, Penstock’s SaaS payment integrity solution, to seamlessly integrate Paradigm’s services and provide payers with access to Paradigm’s resources as part of a comprehensive audit and payment integrity platform.

Governor Kathy Hochul has signed legislation as part of the fiscal year 2025 budget to provide pregnant women with an additional 20 hours of paid sick leave for prenatal care. The budget also includes financial incentives for hospitals to reduce unnecessary C-sections, eliminates cost-sharing for certain pregnancy-related expenses, and invests $37 billion in Medicaid to support the state’s healthcare system. Additionally, the budget prohibits hospitals from suing low-income patients, expands hospital financial assistance programs, and limits medical debt collections.