HEOR

In recent years there has been renewed attention devoted to coordination of medical care services across the continuum of care, particularly in the area of prevention, monitoring, diagnostics, and disease management. This is not entirely new to the U.S. In the early 1990s, as managed care began to widen its reach and increase market share,…

During the recent debates over the Affordable Care Act (“ACA,” or Obamacare) a commonly raised issue was that U.S. health care does not offer much in the way of “value for money.” The argument, generally, is that we spend a lot more in the U.S. relative to comparable countries but in turn receive poor quality…

In the United States, a variety of “usual, customary and reasonable” (UCR) databases are used by health care entities to benchmark their fees (in the case of health care providers) and to create prospectively determined fee schedules (in the case of health care payers). Both of these exercises have essentially the same objective: to assign…