New Jersey Prepares to Launch Accountable Care Organization

New Jersey is one of the first states to experiment with accountable care organizations, or ACOs, a relatively new health care model that is similar to the patient-centered medical home, or PCMH, and that links primary care and subspecialist practices with area hospitals to create an integrated delivery system. Providers are accountable for costs and the quality of care delivered, and bonuses and penalties are tied to overall spending and quality measures. Learn more

Money Saving Tips on Brand Name Medications

The next time your doctor prescribes a name brand medication it may be worth checking online or with your local pharmacy to see if there is any special money saving offers available.  Many of these brand name drugs have their own dedicated websites that will provide  specific information to obtain savings.  

Provided below is a SAMPLE of medications that have special money saving offers.  This is not an all inclusive listing, so if you do not see a particular medication listed you may want to research the medication online.

Check here to see the sample Brand Name money savings list.

Stores Offering Free Antibiotics and Updated $4 Generic Drug Deals

Swine Flu Employee Education

Below are links to a variety of swine flu educational resources that will help you stay on top of the situation. They include:

The CDC has offered recommendations for everyday actions people can take to protect themselves from this new strain of flu.

  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
  • Avoid touching your eyes, nose or mouth. Germs spread that way.
  • Try to avoid close contact with sick people.
    • Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
    • If you get sick, the CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

NJ Prescription Drug Price Registry

The NJ Prescription Drug Registry will help consumers compare retail prices charged by pharmacies for the most frequently prescribed prescription drugs. By comparing prices here, consumers can see what a pharmacy has reported to the state that it charged for a specific Rx. You will find that prices for the exact medication will be different from pharmacy to pharmacy and from town to town. To use this registry click here, this link will also be on the right side of my blog titled NJ Prescription Drug Registry. New York and Connecticut have a similar site called Prescription Drug Prices in New York State and CT Attorney General’s Prescription Drug Page.

 

 

Prescription Assistance Program Loosens Eligibility Guidelines, Expands Access

According to a February 2009 Kaiser Health tracking poll more than 53% of all Americans are cutting back on healthcare in someway because of costs concerns. The most common behaviors are relying on home remedies and over the counter drugs rather than going to the doctor. One in four have put off healthcare that they needed more generally and one in five have not filled a needed prescription and one in six have cut pills in half or skipped doses to make their prescription last longer.

Together Rx Access, a prescription savings program sponsored by some of the nation’s largest pharmaceutical companies, has loosened its income eligibility requirements, thereby expanding the number of health consumers who qualify for the program. Share this anyone who is in need of support.

Getting Free or Low Cost Prescription Drugs

 

Given the significant rise in unemployment and people unable to afford the costs of COBRA may people are going without Rx coverage.  Help is available for people to receive free or low cost prescription drugs thru PAP’s.

 

Patient Assistance Programs (PAP’s) are programs set up by drug companies that offer free or low cost drugs to individuals who are unable to pay for their medication. Most of the best known and most prescribed drugs can be found in these programs. All of the major drug companies have patient assistance programs, although every company has different eligibility and application requirements.

 

Eligibility varies program by program. Generally, individuals must have incomes under 200% of the Federal Poverty Level, cannot have prescription coverage from any public or private source and must be a U.S. resident or citizen. Some companies require that the patient has no health insurance.

 

For more on PAP go to RxAssist and spread the good word.       

  

Cuomo Battles Health Insurance Carriers and Posts a Victory for Consumers and Transparency

Cuomo Speaks Out on Victory

Back in February 2008 I reported NY Attorney General, Andrew Cuomo was investigating United Healthcare and has subpoenaed 16 other health plans including Aetna, CIGNA, Humana, and Well Point a subsidiary of Empire Blue Cross Blue Shield to determine how they calculate UCR. UCR is the usual customary and reasonable payment made for medical services rendered outside of the insurance carrier’s network.

Yesterday United Healthcare agreed to close down two Ingenix databases used to determine usual and customary payment rates for services for out of network doctors and pay 50 M to establish a new database that will be run by an independent nonprofit.  This much criticized database was run by Ingenix a subsidiary of United Healthcare. 

Cuomo’s investigation found that the UCR determined by Ingenix database for claims led to underpayments by iurers anywhere from 10 to 28 percent.   United wasn’t the only carrier using this database.

 

This is a huge victory for healthcare transparency for consumers. Under the agreement the new database will come with a web site that allows consumers to see how much they will be reimbursed for services in their area for out of network services

Free Antibiotics at Stop & Shop

Starting January 2, 2009, and continuing through March 21, 2009, Stop & Shop pharmacies are offering a 14-day supply of the most commonly prescribed generic antibiotics for free. Simply bring in your valid prescription from your doctor.

For a list of participating antibiotics, click here.

For a list of frequently asked questions click here.

2008 Regional Healthcare Report Card

The NYS Health Accountability Foundations has published the 2008 Regional Health Care Report Card, which presents access, service and quality data for all hospitals and commercial managed care plans in New York, New Jersey, Connecticut, Vermont and Rhode Island. 

Review reportcards for Insurance Carriers and Hospitals