Drug discount cards might work against payers' programs
Drug discount programs for consumers can drive high costs.
View ArticlePremium variation remains wide among small groups as costs rise
Premiums for small group insurance fall as size increases and companies gain economies of scale.
View ArticleWithout a team of pharmacists, your ACO will be incomplete
Perhaps the tide will turn as accountable care organizations and patient-centered medical homes make inroads.
View ArticleInvesting in providers
Large health insurers are expanding, diversifying and strategically acquiring on the provider side
View ArticleSpecialty tier falling out of favor because of access issues
Introducing a specialty drug tier to the formulary raises a red flag on access issues.
View ArticlePreferred networks must offer adequate member access
There are a growing number of pharmacy network designs that include member savings for using "preferred" pharmacies, in addition to the savings gained from using "preferred" drugs
View ArticleOrphan drugs target smaller populations with rare conditions
FDA-approved orphan drugs prompt plans to identify members.
View ArticlePlans scramble to optimize shifting generic drug costs
This year might be remembered for its generic pipeline, with as many as 37 drugs coming off patent.
View ArticleManaged care saves budgets in prison facilities
California has adopted some managed care principles, hoping to achieve accessible, cost-effective care.
View ArticleElectronic prior auth offers real time response
Prior authorization doesn't have to rely on paper forms and telephone requests.
View ArticleDrug price guarantees another arrow in the quiver
Are drug-price guarantees here to stay?
View ArticleClinical pathways guide treatment but don't dictate regimens
Oncology pathways can lead to quality programs and more cost-effective care for cancer patients.
View ArticlePart D private market continues to be an industry hot spot
Part D program exceeds industry expectations
View ArticlePayers consider audit process for specialty
Despite front-end scrutiny, payers seek audit process to improve high-cost specialty pharmacies.
View ArticleAdvocate safe use of pain drugs
Plans can help reduce prescription drug abuse by advocating appropriate use.
View ArticleMultidrug therapy for Hepatitis C can reduce treatment timelines
Interferon-free solutions expected soon.
View ArticlePBMs concerned oversight involves conflict of interest
State boards of pharmacy would have access to proprietary data that PBMs want to protect
View ArticleHHS invests $150 million in enrollment
Literacy, language barriers, confusion call for combined efforts to raise awareness
View ArticlePredict drug adherence or pay more in future costs
Pharmacists are an underutilized resource in the effort to keep members adherent
View ArticlePBM Catamaran increases market presence
Catamaran is buying lives and contracts in its race to grow larger, fill in niche gaps
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