Kathryn Phillips Wants to Anticipate Payer Cancer Coverage as Screenings Evolve

04/05/22 • 24 min

This episode is sponsored by the Rural Health Research Gateway at the University of North Dakota.

Cancer diagnosis has changed radically in the era of precision medicine. New techniques like multi-cancer early-detection screening tests can detect up to 50 types of cancer from a single blood draw.

We generally think of early detection, especially of cancer, as an unambiguously good thing. Given that, you might assume and expect that insurers would readily pay for it. But it turns out the considerations regarding insurance coverage for these screening tests are quite complex.

As is often the case, advances in medical technology have accelerated beyond certain policies that were put in place when cancer diagnosis and treatment were very different.

Kathryn Phillips from the University of California San Francisco joins A Health Podyssey to discuss how we can gain the advantages of better cancer screening technologies as they emerge.

Phillips and coauthors published a paper in the March 2022 edition of Health Affairs examining payment considerations for multi-cancer screening tests. They outline clinical and economic considerations that will have to adjust to meet the new reality.

If you enjoy this interview, order the March 2022 Health Affairs issue to get research on hospitals, health equity, care delivery and more.

Subscribe: RSS | Apple Podcasts | Spotify | Stitcher | Google Podcasts

This episode is sponsored by the Rural Health Research Gateway at the University of North Dakota.

Cancer diagnosis has changed radically in the era of precision medicine. New techniques like multi-cancer early-detection screening tests can detect up to 50 types of cancer from a single blood draw.

As is often the case, advances in medical technology have accelerated beyond certain policies that were put in place when cancer diagnosis and treatment were very different.

Kathryn Phillips from the University of California San Francisco joins A Health Podyssey to discuss how we can gain the advantages of better cancer screening technologies as they emerge.

If you enjoy this interview, order the March 2022 Health Affairs issue to get research on hospitals, health equity, care delivery and more.

Subscribe: RSS | Apple Podcasts | Spotify | Stitcher | Google Podcasts

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Seth Berkowitz Puts A Figure to Social Determinant Health Spending

Limited access to transportation is well established as a barrier to people obtaining health care services. If it's hard to get to the doctor, you're less likely to go and that means delays getting needed care, poorer management of chronic conditions, and more use of the emergency room.

While health insurance typically covers emergency transportation, say for an ambulance, coverage of non-emergency transportation to get you to a doctor's visit is less common. Medicaid, which serves people with low incomes, has covered this type of transportation for decades, but it's become increasingly clear that plenty of people with incomes above the Medicaid eligibility threshold face significant transportation barriers.

Thus, some insurers and health systems have begun to offer a non-emergency transportation benefit as well.

Seth Berkowitz from the University of North Carolina School of Medicine joins A Health Podyssey to discuss the effect of providing a transportation benefit.

Berkowitz and colleagues published a paper in the March 2022 issue of Health Affairs assessing the effects of a non-medical transportation benefit offered to members of a Medicare accountable care organization.

Enrollees had very positive reactions to the program, but it was also associated with more outpatient visits per person per year and thousands of dollars more in outpatient spending.

If you enjoy this interview, order the March 2022 Health Affairs issue to get research on hospitals, health equity, care delivery and more.

Listen to Health Affairs Pathways.

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Stacie Dusetzina Shares Why Medicare Beneficiaries May Not Fill Specialty Drug Prescriptions

This episode is sponsored by the Rural Health Research Gateway at the University of North Dakota.

The United States is facing a drug affordability crisis.

Even as we celebrate scientific discovery, the health benefits of drugs are limited due to barriers of affordability, often even for people with health insurance. The RAND Corporation reports that on average drug prices in the United States are more than two and a half times those in 32 other nations studied. The disparities are even wider when we focus just on brand name drugs.

Drug pricing is the subject of seemingly perennial debates. One side focuses on access barriers due to high prices while the other side argues that lower prices threaten future innovation.

Stacie Dusetzina from Vanderbilt University Medical Center joins A Health Podyssey to talk about the complex world of drug pricing.

She and colleagues published a paper in the April 2022 issue of Health Affairs examining the degree to which people with Medicare prescription drug benefits use the drugs that are prescribed to them.

In the paper, the authors found non-initiation rates among some beneficiaries of greater than 50 percent for certain treatments.

If you enjoy this interview, order the April 2022 Health Affairs issue to get research on access to care, hospitals and more.

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