HFMA October 3, 2022
Lola Butcher

Healthcare researchers believe Medicare could save $2 billion by using a cheaper drug for retinal disease, but some physicians don’t want to switch.

Population health experts at CommonSpirit Health have singled out a costly drug with a much cheaper alternative that is not being prescribed by many physicians who could.

If just a portion of those non-prescribing physicians switched to the lower-cost retinal disease drug, researchers at Chicago-based CommonSpirit estimate that it would generate yearly savings for Medicare of $2.3 billion, an amount that exceeds the annual savings from the entire Medicare Shared Savings Program (MSSP).

The situation underscores some major flaws both with CMS’s payment model for the drugs involved and with the structure of Medicare...

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Oliver Wyman

Topics: ACO (Accountable Care), CMS, Govt Agencies, Health System / Hospital, Healthcare System, Insurance, Medicare, Payment Models, Pricing / Spending, Provider, Value Based
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