Laura Joszt, MA

Although Rhode Island is the smallest state in the United States, it had the fourth highest healthcare spend, which meant the state was spending "way too much" on healthcare, according to Beth Hebert-Silvia, RPh, managing director and assistant vice president of pharmacy at Blue Cross and Blue Shield of Rhode Island (BCBSRI).

Although there is a lot of promise for comparative effectiveness research as a tool to help healthcare providers, policy makers, and patients make better decisions, there are a number of issues to be resolved, according to speakers at the Academy of Managed Care Pharmacy's 27th Annual Meeting & Expo.

In a session at AMCP's 27th Annual Meeting & Expo that was so popular that attendees were being directed to an overflow room, Aimee Tharaldson, PharmD, senior clinical consultant in emerging therapeutics at Express Scripts, highlighted specialty pharmaceuticals that are currently in development and expected to come to the market in the next few years.

Pharmaceutical pricing is opaque for a reason and increased transparency may not be a benefit, said the speakers during the "Drug Pricing: Manufacturer, Payer, Prescriber, and Patient Perspectives" session at the Academy of Managed Care Pharmacy's 27th Annual Meeting & Expo in San Diego, April 7-10.

Trends in healthcare are driven by innovation, which is largely being driven by specialty innovation, Douglas M. Long, MBA, vice president of industry relations at IMS Health, said during the headline session "Marketplace Trends" at the Academy of Managed Care Pharmacy's 27th Annual Meeting & Expo.

As more high-cost drugs reach the market, the meaning of value gains more attention, especially in the specialty pharmacy market. One way to assess value is to use a cost-effectiveness analysis to guide formulary decisions.

The amount of care provided in California emergency departments for non-injuries, like complex, chronic conditions has increased, according to a study led by the University of California, San Francisco.

With 6 million people enrolling in their benefits on a private health insurance, the market has seen annual growth in excess of 100% since 2013, and forecasts don't show the trend slowing, according Accenture.

Instead of the original 0.95% rate cut for the Medicare Advantage (MA) program proposed in February, CMS announced on Monday that the MA pay rate for 2016 would be a 1.25% increase.

Accountable care organizations can leverage health information technology to improve patient safety without creating alert fatigue among providers, according to a study in the Journal of Managed Care & Specialty Pharmacy.

The Workgroup for Electronic Data Interchange sent a letter to HHS Secretary Sylvia M. Burwell on March 31 explaining that the 1-year delay for implementation of the International Classification of Diseases, Tenth Revision may have done more harm than good.

Implementing a value-based drug formulary that uses cost-effectiveness analyses after safety and efficacy decreased pharmacy costs by 3% in the first year, according to a study published in the Journal of Managed Care & Specialty Pharmacy.

The prevalence of major depressive disorder (MDD) grew from a rate of 6.4% in 2005 to 6.8% in 2010 with the cost of MDD to employers increasing 21.5% over the same time period, according to a new study in the Journal of Clinical Psychiatry.

Contributions from employers and workers to health savings accounts were on the decline in 2014, according to new research from the Employee Benefit Research Institute.

The Robert Wood Johnson Foundation's advisory committee for the Data for Health initiative released its first report with insights, concerns, and ideas from the public about how to harness data to improve health.

States that decide to carve out their pharmacy benefits from Medicaid plans have significantly higher costs, according to a report requested by America's Health Insurance Plans from The Menges Group.

Physicians were accepting nearly equal amounts of new Medicare and privately insured patients in 2013, but much fewer were accepting new Medicaid patients, according to a new report from the CDC's National Center for Health Statistics.

Although healthcare stakeholders view comparative effectiveness research (CER) as important to healthcare, respondents to a survey from the National Pharmaceutical Council admitted that they haven't yet seen the impact of CER.

The Supreme Court of the United States ruled on Tuesday that providers cannot sue states over low Medicaid reimbursement rates, overturning the decision of the lower court.

The Affordable Care Act's insurance exchanges leave much to be desired with regard to transparency when patients are shopping for health coverage, according to a survey from the National Health Council.

Increased insurance coverage under the Affordable Care Act not only did not cause a sharp increase in new patients, but there has not been any change in how sick patients were who sought care, according to a report from athenahealth and the Robert Wood Johnson Foundation.

Although the Supreme Court's decision on King v. Burwell could remove subsidies from the federal marketplace, Americans prefer HealthCare.gov over the state-run exchanges, according to poll results from right-wing advocacy group Foundation for Government Accountability.

When Aledade launched in 2014, founder Farzad Mostashari, MD, former national coordinator for health information technology (IT), was spending about half the time talking to doctors not about his new company, but about value-based payments and what accountable care organizations were.

During his closing keynote at the World Health Care Congress, former Speaker of the House Newt Gingrich echoed the sessions of the previous 3 days by discussing current and future change in healthcare.

The adoption of the Affordable Care Act's medical loss ratio provision, which requires insurers spend 80%-85% of premiums on medical care and quality improvement, has yielded large benefits for consumers from 2011 to 2013.

The Health Care Payment Learning and Action Network kicked off with its inaugural meeting bringing together public and private sector actors to discuss efforts to move healthcare toward a system that pays based on quality rather than quantity.

With the Affordable Care Act's requirement that most nongroup health insurance plans offer minimum coverage standards, concerns arose about plan cancellations affecting those who already had insurance coverage. However, recent data found cancellations were uncommon.

On the fifth anniversary of the Affordable Care Act, HHS' Office of the Assistant Secretary for Planning and Evaluation announced that healthcare reform was responsible for a $7.4 billion reduction in uncompensated care costs in 2014.

Big data, interoperability, and patient engagement were the topics of discussion during one of the opening keynote sessions at the World Health Care Congress held March 22-25 in Washington, DC.

More than $3 billion was returned to the Medicare Trust Fund in 2014 from individuals and companies attempting to defraud federal health programs, according to an announcement by HHS.