Wakely Wire

New Insights

Whitepapers, briefs, press releases and more

Is PC Flex Right for Your ACO?

The Primary Care Flex (PC Flex) model is a new Center for Medicare and Medicaid Innovation (CMMI) model developed to further test how alternative payments for primary care services (PCS) can empower Accountable Care Organizations (ACOs) to use more innovative, team-based, person-centered, and proactive approaches to care that positively impact health care outcomes, quality, and ... Read more

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Newsworthy Findings

Uninsured Rate Expected to Hit 8.9% Over Next Decade, CBO Finds

New government projections chart the dogged rise in the nation’s uninsured rate as policies that swelled healthcare coverage during the coronavirus pandemic expire.

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Editor's Note
The ending of covid-era protections is leading to higher uninsured projections. The Medicaid continuous enrollment provisions ended last spring and the enhanced ACA subsidies are set to expire next year.

Biden Administration Gives Providers Grace Period to Open Surprise Billing Arbitration

Because of the cyberattack on Change Healthcare earlier this year, providers say they’re having difficulty getting the necessary information from plans required to kick off dispute resolution.

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Editor's Note
The Labor and Treasury departments are giving providers impacted by the attack 120 days after the publication of the notice to initiate open negotiation for any services furnished this year and noted that this window could be extended.

The Need for Sustainable Healthcare: Beyond Private Equity

In recent years, the landscape of emergency medicine has seen a marked increase in private equity (PE) investments in physician groups.

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Editor's Note
Private equity's business model, with its focus on quick returns, often leads to cost-cutting measures that can significantly compromise the quality of patient care. This includes staff reductions and a shift towards high-revenue services, which can detract from the holistic care patients need, creating an environment where profitability overshadows patient needs.

‘We’re Flying Blind’: CDC Has 1M Bird Flu Tests Ready, but Experts See Repeat of Covid Missteps

It’s been nearly three months since the U.S. government announced an outbreak of the bird flu virus on dairy farms. The World Health Organization considers the virus a public health concern because of its potential to cause a pandemic, yet the U.S. has tested only about 45 people across the country.

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Editor's Note
As the outbreak grows researchers said the CDC and FDA are not moving fast enough to remove barriers that block clinical labs from testing.

Mark Cuban's D2C pharmacy won't beat most insured patients' out of pocket drug prices, one study finds

Insured patients typically benefit more from using their health insurance for generic prescriptions rather than purchasing them from the Mark Cuban Cost Plus Drug Company, although uninsured patients may see significant cost savings.

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Editor's Note
This study highlights that while the Mark Cuban Cost Plus Drug Company can offer substantial savings for uninsured patients, payers need to consider that insured patients generally incur lower out-of-pocket costs through their existing health insurance benefits.

Bonus Article

Lung Cancer Drug Elicits Unprecedented Results in New Trial

The phase III trial of lorlatinib, a third-generation ALK-inhibitor, has shown unprecedented five-year progression-free survival rates for patients with advanced ALK-positive non-small cell lung cancer, marking a significant advancement in treatment outcomes.
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Just for Fun

Math Riddle:

What number has the same number of letters as its value?

Prior Week

Q: What do you get when you take the sun and divide its circumference by its diameter?
A: Pi in the sky