Solving Your Coverage Policy Challenges with Evidence: A Hayes Webinar

Posted by Maura Connor, Chief Operating Officer on June 22, 2017

When it comes to making any coverage policy determination, payers must consider answers to the following questions:

Does the technology work?

Is it safe?

For whom does it work?

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Topics: Payers, Hayes Blog

Questions About Genetic Test Coverage? We’ve Got Answers.

The rapid rise in the number of commercially available genetic tests, along with the growth of a genomic approach to healthcare, can make you feel as though you are standing at the entrance to a complicated maze. Not only are there currently more than 65,000 tests available, but many of these tests have their twists and turns in the form of classifications and subdivisions, with little to no quality research to prove their reliability, safety, and efficacy. This raises doubts not only about the ethics of performing some of these tests, but about which tests to cover.

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Topics: Payers, Hayes Blog, Genetic Testing, Health Technology Assessments,

Pharmacogenomics and Mental Health: Discover the Link at the 2017 Client Symposium

The relatively new science of pharmacogenomics is getting an increasing amount of attention as of late. According to the NIH, it is defined, somewhat simply, as “the study of how genes affect a person’s response to drugs.” It was born out of the fact that current drugs on the market are designed to essentially be a “one-size-fits-all” solution to a particular health problem. However, anyone who has had the patience to sit through the list of disclaimers in a drug commercial or strained their eyes reading the litany of potential side effects a pharmaceutical might have understands that drugs affect different people in different ways, despite their having the same condition. Some may experience the relief they seek, fulfilling the purpose of the drug with little to no ill side effects, while others may experience significant adverse conditions, including (rarely) death. The study of pharmacogenomics presumes that this is likely due to sequence variants in the patients’ genes.

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Topics: Payers, Hayes Blog, Health Technology Assessments,

June Is Alzheimer’s and Brain Awareness Month! What Is the Latest Research?

You might notice a preponderance of people wearing purple this month. That’s because it’s the signature color of the Alzheimer’s Association’s “Go Purple” initiative to raise awareness about the devastating effects of the disease. Discovered by Dr. Alois Alzheimer in 1906, the disease is defined by the National Institute on Aging (NIA) as “an irreversible, progressive brain disorder that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest tasks.” It is estimated that more than 5 million Americans may have Alzheimer’s, and that it may rank as the third most common cause of death for older people, superseded only by cancer and heart disease.

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Topics: Payers, Hospitals, Hayes Blog, Health Technology Assessments,

Employer-Funded Insurance: Does Evidence Play a Role in Its Success?

Posted by Silvana Schneider, Director Payer Services on May 31, 2017

The quagmire that is the American healthcare system continues to leave payers, providers, and patients wringing their hands with the uncertainty of what lies ahead. Tired of waiting for the other shoe to drop and unwilling to leave their valuable employees without the coverage they need for themselves and their families, some companies have gone the self-funded, self-insured route. This path, while innovative and admirable, is not without complications and is not entirely immune from the current issues swirling around healthcare reform.

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Topics: Health Technologies, Payers, Hayes Blog, Health Technology Assessments,

Speakers Confirmed for Hayes 2017 Client Symposium

We are pleased to announce our lineup of guest speakers for this year’s Client Symposium. In addition to our keynote speaker, we are featuring two professionals who bring years of healthcare expertise and experience to our second annual gathering in the city of brotherly love.

The credentials of these sought-after presenters speak for themselves, so I’m going to let them do just that. Once you’ve read about their impressive backgrounds and accomplishments, head over to our registration page and reserve your spot at the Client Symposium today!

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Topics: Payers, Hayes Blog

NPR Segment Features Treatments for Low Back Pain

Last week, as part of their “Your Health” segment, NPR aired a piece about the effectiveness of various treatments for low back pain, with a focus on spinal manipulation. Lower back pain is a common complaint to physicians, and, as the article states, a common reason for the prescription of addictive narcotic painkillers. Other interventions can include:

  • Acupuncture
  • Physical therapy
  • Massage therapy
  • Nonsteroidal anti-inflammatory drugs (NSAIDS)
  • Chiropractic treatment
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Topics: Payers, Hospitals, Hayes Blog, Devices, Health Technology Assessments,

Top 3 Hayes Reports: 1st Quarter, 2017

Who doesn’t love lists? Especially lists detailing the best of the best, the most popular, the most in-demand. To that end, we’ve compiled a list of our top three Directory reports for the first three months of the year, in order of retrievals from our Knowledge Center. These three represent a mix of information important to both payers and providers.

If you’re already a subscriber, you can check out these reports at any time. If you’re not a Hayes member…what are you waiting for? Don’t forget, you can also purchase an individual report. Contact us to find out how.

Let’s get to the top three!

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Topics: Payers, Hospitals, Hayes Blog, Health Technology Assessments,

On the Horizon: CAR T-Cell Therapy for Cancer Treatment

Traditional cancer treatments include procedures with which we’re all familiar: chemotherapy, surgery, and radiation therapy. But clinicians and scientists continue to work tirelessly to find a cure for the devastating disease. While immunotherapy has been in the news as of late as relates to the treatment of peanut allergies (see our blog, Peanut Allergy Drug Therapies Make National Headlines), there have been advances in its use for the treatment of cancer over the past few years. There are several biologic agents that are FDA approved for different cancers; these targeted therapies are aimed at destroying cancer cells without the troublesome side effects that accompany traditional cancer treatments.  

But there’s something new on the horizon from the world of immunotherapy.

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Topics: Health Technologies, Payers, Hospitals, Hayes Blog

Does Evidence Have a Role in Treating the Opioid Epidemic?

America has an opioid problem.

According to a 2016 report from the American Society of Addiction Medicine (ASAM), drug overdose is the leading cause of accidental death in the U.S., with 52,404 lethal drug overdoses in 2015. Of that number, 20,101 overdose deaths were related to prescription opioid pain relievers and 12,990 overdose deaths were related to heroin in 2015. In 2012, 259 million prescriptions were written for opioids; 80% of new heroin users began by misusing prescription painkillers. 

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Topics: Health Technologies, Payers, Hospitals, Hayes Blog

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