In the latest episode of the Debunked Podcast, co-hosts MedCity News Editor-in-Chief Arundhati Parmar and Samir Batra, managing partner of Health Innovation Pitch, listed potential ways to reform pharmacy benefit managers. Samir also offered his views on a bipartisan bill from Senator Elizabeth Warren (D-MA) and Josh Hawley (R-MO) to mitigate the impact of consolidation on the healthcare industry.
Other highlights of the discussion include the conflict between Elevance Health and CMS. For the past 7 years, Elevance failed to submit data backing up its members’ risk adjustment scores through the electronic system CMS provides. Instead, it has submitted the data on encrypted flash drives. If Elevance does not comply with CMS, it risks being suspended from adding new enrollments to Medicare Advantage plans. These members account for an estimated 5% to 6% of Elevance’s revenue.
Hims & Hers’ move to acquire Eucalyptus in a $1.15 billion deal led Arundhati and Samir to ponder how the deal could be leveraged by the business to make the companies a global brand.