Cost of Care

CSC Counters COVID-19
Thanks to the generous support of individuals and corporate partners, the Cancer Support Community (CSC) has taken swift action to adapt and increase the availability of its free patient-focused support and navigation services during this unprecedented global public health challenge.

Prior Authorization: What Patients Need to Know
One of the major themes dominating health care discussions today is that health care costs in the United States are proving unsustainable. Practices known as utilization management (UM) are one of the attempts the cost of health care has been addressed. The Cancer Policy Institute (CPI) at the Cancer Support Community (CSC) is releasing a series of blogs aimed at educating patients about different UM practices and techniques, how it impacts access to care, as well as advocacy opportunities to address those barriers to care. Read this second blog in the series to learn more about Prior Authorization. Missed the first blog? Read it now!

Utilization Management - What Is It and Why It Matters
Chances are that you’ve never heard Utilization Management unless you’re in the industry, but you have probably heard of or experienced “prior authorization” and maybe...

Utilization Management: What Patients Need to Know
One of the major themes dominating health care discussions today is the fact that healthcare costs in the United States are proving unsustainable. Practices known as utilization management (UM) are one of the major ways the high cost of health care has been addressed. The Cancer Policy Institute at the CSC will be releasing a series of blogs aimed at educating patients about different UM practices and techniques. The upcoming blogs will contain information that patients need to know, including how that particular technique impacts access to care, as well as advocacy opportunities to address those barriers to care. Read this first blog in the series to learn more about UM, the different practices and techniques, and how CSC is fostering conversations about UM.

The High Cost of Five Percent: The Importance of Capping Annual Out-of-Pocket Prescription Drug Costs for Medicare Part D Beneficiaries
Approximately 43 million Americans are enrolled in Medicare Part D - a voluntary outpatient benefit provided through private health insurance plans approved by the federal government. These plans assist seniors in affording their prescription medications. However, for people with complex and serious health conditions who depend on high-cost drugs, affording medications under Medicare Part D is becoming more and more difficult. Read our break-down of the different payment phases in Medicare Part D and an explanation of why imposing a cap (limit) on the amount beneficiaries pay out-of-pocket each year for prescription drugs is more important than ever.

Medicare Part D Cancer Drugs Continue to be Protected
Medicare Part D is a voluntary outpatient prescription drug benefit to assist people in affording their prescription medications. Part D benefits are provided through private health insurance plans and approved by the federal government. Participants in Part D are able to choose between supplementing their traditional Medicare with a stand-alone prescription drug plan or a Medicare Advantage prescription drug plan that is part of and includes other aspects of Medicare. In November, 2018 the Centers for Medicare & Medicaid Services (CMS) proposed a new rule for Part D that would have changed the special coverage protections for medications included in the six protected classes.

Shared Decision Making and Value Based Cancer Care Research
The United States health care system has been evolving at a rapid pace with attempts to control costs while also improving outcomes for patients. Cancer care is at the center of these debates with 15.5 million cancer survivors and per person treatment costs exceeding all other diseases. Policy and decision makers are shifting from a volume-based system to value-based care in an effort to ensure that patients are receiving high-quality care at the lowest possible price. Click here to learn more about our most recent published journal articles to delve deeper into our research into value-based care designs.

New Transparency Laws Could Help Patients Reduce Out-of-Pocket Drug Spending
President Trump recently signed two bills into law aimed at reducing patients’ out-of-pocket spending on prescription medications. The “Patient’s Right to Know Drug Prices Act” and the “Know the Lowest Price Act” address a practice known as “gag clauses.”