Payer’s Place: David Calabrese
OptumRx's Chief Clinical Officer shares his insights on the latest developments and trends he's seen in the healthcare industry.
House Committee Chairman Launches Investigation into PBMs, Rising Drug Costs
James Comer (R-Ky), House Committee on Oversight and Accountability chairman, sent letters to the Office of Personnel Management, Centers for Medicare and Medicaid Services and the Defense Health Agency asking for documents that show how PBMs’ practices are affecting federal government healthcare programs. In addition, he sent letters to CVS Caremark, Express Scripts and OptumRx, asking them to provide information on their tactics.
With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
Q&A: As Congressional Heat Builds on PBMs, What Is the Message From the Industry Lobby?
The largest six pharmacy benefit managers are being scrutinized by the Federal Trade Commission, while Congress is debating the Pharmacy Benefit Transparency Act. Meanwhile, states have their own ideas for reining in what they see as excesses of the industry. With all this heat, what is the message from the head of the Pharmaceutical Care Management Association?
Getting off the PBM Merry-go-Round: How Late-stage Offer Tricks Take Employers for a Ride
Requiring that PBMs bid on a per member per month guarantee would reduce the employer’s uncertainty by securing the actual per member per month cost to the employer.
Why are Healthcare Costs So High? Blame the Middlemen
Large employers, particularly self-insured companies, can demand a better and fairer system. They can use their contracting power to insist that their plans cover all FDA approved drugs.
Telehealth, online pharmacy key focus for UnitedHealth, leaders say
UnitedHealth's 2020 revenue jumped by $15 billion from the year before. As the payer gears up for 2021, leaders except to see demand for telehealth and online pharmacies continue, driving their focus on these services.
presented by
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
Some startups grapple with USPS delays in medication delivery
Some healthcare startups that offer at-home prescription deliveries and test kits have experienced delays with the USPS. They shared how they're navigating the changes.
Why a VC frustrated by the PBM industry decided to start an alternative
Boston, Massachusetts-based WithMe Health launched out of stealth with $20 million in funding and Oak HC/FT Partner Chris Price at the helm.
Justice Department approves $69 billion CVS Health-Aetna deal
Regulatory approval for the purchase is predicated on Aetna's previously announced plans to sell off its Medicare Part D business to WellCare Health.
PBM practices harm care for cancer patients, oncology professional group says
In a position statement, ASCO said PBM practices can result in medication dispensing errors, harm physicians' ability to treat patients and drive up costs.
Maximize Revenue and Patient Care with Strategic Weight Loss Management
We will highlight Build My Health's revenue practice management tools, which could help physician practices add up to $250,000 to their practices.
Report: Government can put an end to PBM drug rebates, HHS secretary says
Cracking down on manufacturer rebates for PBMs is part of administration plan to cut drug and out-of-pocket costs.
UnitedHealthcare personalizes Health4Me app to close care gaps
Before the end of the year, UnitedHealthcare will add "clinically focused" notifications to Health4me, based on individuals' claims data.