HMPI

Word from the Editor

We’re very excited to bring you this issue of HMPI. Thanks to a generous gift from the Ludy Family Foundation, we have been able to reformat HMPI for its second decade. The biggest changes are behind the web page where we have formatted the journal for Google Scholar with searchable meta-data. Many thanks to Managing Editor Kirsten Gallagher and her team for the hard work to make this transformation happen! Beyond the new format, you’ll see articles we have solicited on timely topics in the health care market.

One perspective missing from the drug re-importation debate in the US is that of Canada. In our featured article, we will learn Paul Grootendorst how the Canadian government and Canadian manufacturers have built legal mechanisms to protect their market and their drug supply. Medicare Advantage is in the news and is studied in many of our programs as a financial model, but what is it like to experience Medicare Advantage from the perspective of an enrollee. We have a very personal account of end-of-life care from Neil Fleming. PBMs constantly confuse students (and policy makers) on their role in the market. Rena Conti, one of the country’s experts on this industry, provides a careful overview of PBMs, some of their potential benefits and some of their challenges.

Reimbursement remains a challenge for many new medical products. New data document the barriers to establishing reimbursement codes from the innovators perspective. Prior authorization is also in the news. We’re grateful for a timely review of this health plan feature from Austin Allen and Markus Saba. Other articles this month include perspective on organizational innovation from Dick Levy, who built Varian and has served on over 20 public and private boards, an update on CMS price transparency rules from Steve Parente, who helped develop this policy during his time in the White House, a review of the University of Miami’s latest healthcare conference from Karoline Mortensen, Steven G. Ullmann, and Richard Westlund, and workforce challenge recommendations by the winners from our 2024 BAHM Case Competition, Angela Botiba, Divine Mercy Bakare, and Erika Schlosser. Finally, we have a new case study on administrative costs, and an overview of Robert Pearl’s new book.

Kevin Schulman, MD, MBA
BAHM President & HMPI Editor-in-Chief
Professor of Medicine, Stanford University