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Survivor Views on Artificial Intelligence and FDA Medical Product Reviews

... of cancer patients and survivors agree that the industries making FDA-regulated products should provide some of the cost of FDA’s public health oversight Cancer patients and survivors mirror the American public in their hesitancy to embrace AI, with 51% reporting they are more ... excited about the technology compared to only 5% who are more excited than concerned. Respondents have mixed expectations of the impact of AI on health care, with a plurality (39%) predicting the impact over the next 20 years to be equally positive and negative. Cancer patients and survivors offer ...

The Medicare Appeals Process: Reforms Needed to Ensure Beneficiary Access

... for a needed service or treatment, cancer patients face having to pay the full cost out of pocket or making the difficult decision to forego care that could save their lives.  To better understand how the Medicare program’s appeals process works for beneficiaries who have a history of ... or Part D plans) to override utilization management tools. Evidence suggests that plans’ initial denials are often overturned : In 2019, the Health and Human Services (HHS) Office of the Inspector General released a report on the Part D appeals process and found that enrollees and ... should be covered by Medicare or choose to forgo care altogether instead of appealing, which could have negative implications for their overall health and wellbeing.    The Medicare Appeals Process: Reforms Needed to Ensure Beneficiary Access ...

Step Therapy in Medicare Part D Oncology Drugs

Executive Summary Escalating drug costs in the United States are placing pressure on both the federal government and health plans to implement strategies aimed at controlling drug expenditures and optimizing utilization. Utilization management (UM) tactics are ...   SNPs provide the same Medicare Parts A and B coverage for beneficiaries as other MA plans but also offer tailored benefits and coordinated care for beneficiaries that have specific health conditions or meet other requirements. Step Therapy in Medicare Part D Oncology Drugs ...

Survivor Views: Copay Assistance and Patient Navigation

... note at end). The margin of sampling error associated with a sample of this size is +/-2.8% at a 95% confidence level.  Key Findings: Cancer care is expensive and prescription drug costs are a challenge for nearly one-third of cancer patients and survivors (31%), with one-fifth having ... the survey. For this survey, a patient navigator was defined as follows: “Patient navigators help guide patients through the often-complicated health care system with the resources they need to get care. A patient navigator helps patients communicate with their healthcare providers so they get the information they need to make decisions about their health care. Patient navigators may also help patients set up appointments for doctor visits and medical tests and get financial, legal, and social ...

Utilization Management in Breast Cancer and Hepatocellular Carcinoma

Executive Summary Utilization management (UM) refers to a variety of practices that health plans and pharmacy benefit managers employ to confirm the use of specific drugs or services aligns with the payer’s policy. Plans can use ... necessary, or to limit utilization of high-priced, specialty medications. UM use in oncology may have unintended consequences to patient care, such as delaying patient access to medication or increased administrative burden for the patient and provider. Prior to 2019, Medicare ...

National Screening Survey

... say they aren’t sure and don’t regularly have a provider who lets them know when it’s time for a screening. Those with employer-provided health plans and Medicare enrollees are significantly more likely to say they know what their recommended screenings are and when to get them (69% ... annually compared to 55% of those in households earning less than $55k per year). Ninety-four percent of respondents report having a primary care doctor, and 93% say they typically see a primary care doctor at least once per year. Ninety-one percent have seen a primary care doctor within ... advocacy affiliate, ACS CAN has successfully advocated for billions of dollars in cancer research funding, expanded access to quality affordable health care, and advanced proven tobacco control measures. We stand with our volunteers, working to make cancer a top priority for policymakers in ...

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