This week, we were fortunate enough to have a conversation with Dr. Nierman of Tufts Health Plan, located in Watertown, MA. The Tufts Health Plan is a nonprofit organization, founded in 1979, that is nationally recognized for its commitment to providing innovative, high-quality healthcare coverage. The plan offers members and employers an array of health management programs, which support evidence-based approaches to health and wellness. Dr. Nierman has served as the Medical Director for Medical Policy for more than 18 years, and took the time to speak with us regarding why the plan made the decision to subscribe to Hayes for our unbiased evidence evaluations to better serve their health plan members.
After the rousing success of our inaugural client symposium, it only made sense to have it become an annual affair. We’re happy to announce that both the date and location have been confirmed for the second Hayes, Inc. Client Symposium!
As with our maiden event, the Hayes Client Symposium is an opportunity for our health plan clients to learn about current and future trends in the industry, including the ability to earn continuing education credits with two accredited sessions. Additionally, both at dinner and during scheduled breakouts, clients will have the opportunity to network both with Hayes employees as well as with each another.
Meaning “porous bone,” osteoporosis occurs when the body loses or makes too little bone. The appearance of osteoporotic bone under a microscope does not reveal the traditional dense “honeycomb” pattern that gives the bone stability. Instead, the patterns are almost web-like, with large holes where smaller ones would normally be, causing the bone to be quite fragile. Depending on the severity of the condition, incidents as severe as a fall to as minor as a cough can cause bones to fracture, most commonly the vertebrae (spine). And unfortunately, chances are good you know or have known someone suffering from one of these fractures.
Genetic testing is seemingly everywhere today. No longer are discussions of tumor profiling, gene panels, genomics and proteomics confined to the scientific realm. Major news outlets cover new advances in genetic testing, as well as some of the hidden risks associated with their exponential growth in the consumer market (See our blog Evidence Shines a Light on the Hidden Dangers of Genetic Testing). Technical innovations, such as next-generation sequencing, have accelerated the development of such tests. Consequently, there is increasing demand on you as both physicians and payers to provide your patients and clients with the best possible test solutions. But how do you decide? There are three essential criteria to consider when making your determinations regarding genetic testing.
Spinal muscular atrophy (SMA) is a genetic disorder characterized by loss of motor neurons, leading to weakness and wasting of muscles used for activities such as crawling, walking, sitting up, and controlling head movement. In severe cases of SMA, the muscles used for breathing and swallowing are affected. This devastating disorder affects approximately 1 in 10,000 births and is the most common genetic cause of infant mortality. SMA is caused by deletions or mutations in a gene that leads to a deficiency of survival motor neuron (SMN) protein; this protein is critical for the maintenance of motor neurons. The severity of SMA is directly related to the amount of SMN protein.
2016 marked a banner year for our company. We are humbled by the loyalty of our ever-expanding client roster. At the same time, we take great pride in what we’ve accomplished over the last 12 months and we’d like to share some of those endeavors with you here. If you’re new to Hayes, or not yet a member, we invite you to view just a sample of the innovation and growth we’ve experienced as an indication of things to come.
So without further ado…
Documented evidence of the use of honey for medicinal purposes has existed for centuries across continents and cultures. As is so often the case, what’s old is new again, and honey has seen a resurgence as a treatment, specifically as a topical ointment to aid in wound healing. Because of its antimicrobial properties, honey is often used when treatment with antibiotics and antiseptics have failed. The honey produced by the Manuka (species Leptospermum scoparium) flower of New Zealand has been shown to be one of the most powerful in this regard.
As 2016 draws to a close, we here are keeping our eyes fixed on the future for you. Increasingly healthcare-savvy patients want their providers to be up to date on the latest health technology advances, no matter what their stage in the FDA approval process. And while both patients and physicians may want these new drugs, procedures, or devices, payers may be equally unaware of the safety, efficacy, or patient appropriateness of the technologies they’re being asked to cover, particularly when they’re new to market and the peer-reviewed, published evidence is scarce.
You can’t get away from the word “value” in today’s healthcare environment. It’s in practically every headline of every blog, whitepaper, and email blast. From value-analysis teams to value-based medicine and purchasing, the word has become so commonplace, it risks losing its own value. With the continued shift away from fee-for-service medicine and toward pay-for-performance, we’ll need to embrace value as not only part of our vocabulary, but as a guide for our business practices. Along those lines, I’d like to take the opportunity this week to tell you about our business values; about how they make us the obvious choice for your health technology assessments; and about how our adherence to those values cost us $100,000.
With respect to health technologies, the cornerstone of any coverage policy determination requires an understanding of the following:
Does the technology work?
Is it safe?
For whom does it work?