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Prescription Rebate Guarantees: Employer Insights

July 19th 2024

This study examined employers’ understanding of rebate guarantees, dependency upon rebate dollars, and the role that pharmaceutical rebates or employer benefits consultants play in their pharmacy benefits manager selection.

To Expand Access to Cancer Expertise, Collaboration Is Key
To Expand Access to Cancer Expertise, Collaboration Is Key

February 20th 2023

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What We’re Reading: Pediatric Vaccine Schedule Updated; Workplace Toll on Health; Drugmakers Lobby Against IRA Impact

October 21st 2022

Headlines overwhelming person.
Taking Action Against the Rising Mental Health Crisis: Efforts From Health Plans, Congress, and More

May 10th 2022

Disparities in Health Care Use Among Low-Salary and High-Salary Employees

May 9th 2022

How Can Employers Safely Return Employees to the Workplace?

Recognizing trends in health care that align with the COVID-19 pandemic and related racial disparities can improve the design of timely and effective strategies by employers to safely return employees to the workplace.

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What We're Reading: FDA Clears Breast Cancer Drug; ACA Numbers Steady; Sutter Settles Case
December 23rd 2019

What We're Reading: FDA Clears Breast Cancer Drug; ACA Numbers Steady; Sutter Settles Case

AJMC Staff
The FDA approved [fam-] trastuzumab deruxtecan-nxki, which will be marketed as Enhertu; preliminary CMS numbers show that 8.3 million people enrolled in coverage under the Affordable Care Act (ACA) from November 1 to December 17, about 2% fewer than last year; Sutter Health agreed to pay $575 million to settle claims of anticompetitive behavior brought by the California state attorney general as well as unions and employers.
Dr Bruce Sherman on How Employers Can Accelerate Movement Toward Value-Based Models
December 20th 2019

Dr Bruce Sherman on How Employers Can Accelerate Movement Toward Value-Based Models

Progress toward value-based payment models is moving slowly, so employers and healthcare systems need to recognize the value of taking on risk and encourage surrounding entities in their communities to do the same, said Bruce Sherman, MD, chief medical officer of the National Alliance of Healthcare Purchaser Coalitions.
Healthcare Trends to Watch in 2020: National Business Group on Health Highlights Growing Initiatives Among Employers
December 19th 2019

Healthcare Trends to Watch in 2020: National Business Group on Health Highlights Growing Initiatives Among Employers

Matthew Gavidia
The National Business Group on Health released its list of healthcare trends to watch in 2020, highlighted by growing employer initiatives on high quality, high value healthcare, and an increased focus on mental health issues.
PwC Health Research Institute Unveils Impending Top Health Industry Issues of 2020
December 13th 2019

PwC Health Research Institute Unveils Impending Top Health Industry Issues of 2020

Matthew Gavidia
In PwC Health Research Institute’s report, “Top health industry issues of 2020: Will digital start to show an ROI?” researchers highlighted the forces that will most powerfully affect the health industry in 2020, with a chief focus on the concern emerging from revisions to overseas tax provisions.
Bret Jackson Suggests Drivers of Michigan's Low Hospital Prices
December 9th 2019

Bret Jackson Suggests Drivers of Michigan's Low Hospital Prices

The unique market dynamics in Michigan have contributed to lower hospital prices, but it remains to be seen if recent policy changes will reveal these prices to be artificially depressed, according to Bret Jackson, president of the Economic Alliance for Michigan.
Vanessa Sammy Discusses the Importance of Partnerships for Accomplishing Disruption
December 3rd 2019

Vanessa Sammy Discusses the Importance of Partnerships for Accomplishing Disruption

Partnerships are essential for overcoming the barriers to implementing value-based care, explained Vanessa Sammy, MPA, MHSA, senior director of commercial strategy and implementation for Remedy Partners.
Prominence Health Plan Reveals Increased Cost Savings, Improved Quality of Care in Its 2018 Results
December 2nd 2019

Prominence Health Plan Reveals Increased Cost Savings, Improved Quality of Care in Its 2018 Results

Matthew Gavidia
Prominence Health Plan announced that its 7 Universal Health Services (UHS) Accountable Care Organizations (ACOs) revealed a continued trend of increased cost savings and improved quality in 2018 results.
Top 5 AJMC® Articles of November 2019
November 28th 2019

Top 5 AJMC® Articles of November 2019

Here are the top 5 articles for the month of November.
Mental Health Conditions Projected to Be a Significant Factor of Employer-Sponsored Healthcare Benefit Costs, Survey Finds
November 25th 2019

Mental Health Conditions Projected to Be a Significant Factor of Employer-Sponsored Healthcare Benefit Costs, Survey Finds

Matthew Gavidia
Over the next 5 years, mental health conditions are expected to become 1 of the most significant factors attributed to employer-sponsored healthcare benefit costs worldwide, according to survey findings.
Bret Jackson Outlines Findings, Origins, Next Steps of RAND Hospital Pricing Comparison Study
November 25th 2019

Bret Jackson Outlines Findings, Origins, Next Steps of RAND Hospital Pricing Comparison Study

A RAND study comparing hospital prices across states provided insights into the drivers of high healthcare spending in Michigan, explained Bret Jackson, president of the Economic Alliance for Michigan.
Disparities in Access to Behavioral Healthcare for Employer-Sponsored Health Plans Worsening, Study Finds
November 21st 2019

Disparities in Access to Behavioral Healthcare for Employer-Sponsored Health Plans Worsening, Study Finds

Matthew Gavidia
For both in-network access and provider reimbursement rates, disparities between physical and behavioral healthcare is worsening for American families seeking affordable and available mental healthcare and addiction treatment, according to study findings.
Vanessa Sammy on How New Data Tools Help Patients Choose a Site of Care
November 18th 2019

Vanessa Sammy on How New Data Tools Help Patients Choose a Site of Care

New tools enabling data access can help patients choose the most appropriate site of care for their needs, representing a significant change in the care delivery paradigm, according to Vanessa Sammy, MPA, MHSA, senior director of commercial strategy and implementation for Remedy Partners.
Affordability of Healthcare for Employees Cited as Chief Focus of US Employers in Mercer's 2019 National Survey
November 16th 2019

Affordability of Healthcare for Employees Cited as Chief Focus of US Employers in Mercer's 2019 National Survey

Matthew Gavidia
Mercer’s 2019 National Survey of Employer-Sponsored Health Plans highlighted 3 key areas of focus for employers in 2019, which were balancing affordability and choice, empowering employees to improve their health through tech-enabled solutions, and addressing high-cost claims.
This Week in Managed Care: November 15, 2019
November 15th 2019

This Week in Managed Care: November 15, 2019

This week, the top managed care news included Medicaid tightening the reins on supplemental payments; employers needing more data to control benefit costs; experts saying prior authorization mostly burdens patients.
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November 15th 2019

Population Health Screenings for the Prevention of Chronic Disease Progression

Maren S. Fragala, PhD Dov Shiffman, PhD Charles E. Birse, PhD
Identification of chronic diseases in their early stages enables prompt treatment that can slow or prevent disease development and debilitating and costly health outcomes.
How Employers Plan to Manage Healthcare Costs in 2020: A Detailed Report
November 8th 2019

How Employers Plan to Manage Healthcare Costs in 2020: A Detailed Report

Matthew Gavidia
First Stop Health’s inaugural 2019 Health Benefits Cost Containment Report found that reining in benefits spending is a top priority for employers, but many lack the data necessary to make effective changes, according to results of a survey of human resources professionals.
Employer-Driven Sleep Apnea Treatment Program Reveals Significant Healthcare Cost Savings
November 1st 2019

Employer-Driven Sleep Apnea Treatment Program Reveals Significant Healthcare Cost Savings

Matthew Gavidia
An analysis of a carrier-based mandatory obstructive sleep apnea (OSA) program on truckers’ non–OSA-program medical insurance claim costs revealed substantial healthcare cost savings, according to study findings.
Healthcare Purchasing Strategies: How 2 Employers Are Driving Referrals Through RAND Hospital Price Transparency Findings
October 25th 2019

Healthcare Purchasing Strategies: How 2 Employers Are Driving Referrals Through RAND Hospital Price Transparency Findings

Matthew Gavidia
Two employers, Candace Shaffer from Purdue University and Natalie Roberts from Monarch Beverage Company, discuss in a fall webinar series how they have used the RAND Transparency findings to drive referrals.
Michael Thompson Explains How Employers Have Started Addressing Social Determinants of Health
October 24th 2019

Michael Thompson Explains How Employers Have Started Addressing Social Determinants of Health

Employers did not intentionally set out to address social determinants of health, but the programs they were implementing were doing so, said Michael Thompson, president and chief executive officer of the National Alliance of Healthcare Purchaser Coalitions.
Survey Finds 93% of Employers Say Curbing Healthcare Costs Is Top Priority
October 21st 2019

Survey Finds 93% of Employers Say Curbing Healthcare Costs Is Top Priority

Alison Rodriguez
Although 93% of employers say curbing the cost of healthcare and increasing its affordability is a top priority over the next 3 years, 63% of employers see healthcare affordability as the most difficult challenge, according to the 24th annual Best Practices in Health Care Employer Survey by Willis Towers Watson.
What We're Reading: House Committees Pass Drug Pricing Bill; Juul to Halt Some Sales; Employer Groups Form Coalition
October 18th 2019

What We're Reading: House Committees Pass Drug Pricing Bill; Juul to Halt Some Sales; Employer Groups Form Coalition

AJMC Staff
The House Energy and Commerce Committee, as well as the Education and Labor Committee, passed the Lower Drug Costs Now Act; Juul Labs will suspend online sales of several types of flavored e-cigarette pods; a trio of employer groups has formed a new partnership to advocate for policies that address the problem of ever-increasing drug costs.
Michael Thompson Highlights Key Healthcare Areas of Focus for Employers
October 18th 2019

Michael Thompson Highlights Key Healthcare Areas of Focus for Employers

Mental health care is an area of focus for the National Alliance of Healthcare Purchaser Coalitions, because this care is getting worse despite there being more acceptance regarding the need for improved mental health, said Michael Thompson, president and chief executive officer of the National Alliance of Healthcare Purchaser Coalitions.
Higher Employer-Sponsored Healthcare Premiums Occur in Companies With a Predominantly Female Workforce
October 17th 2019

Higher Employer-Sponsored Healthcare Premiums Occur in Companies With a Predominantly Female Workforce

Matthew Gavidia
Higher employer-sponsored healthcare premiums were found to occur in companies where women account for 75% or more, as opposed to 25%, of the workforce, according to a statistical brief.
Majority of Employers Are Willing to Increase Health, Wellness Budgets Compared With 10 Years Ago
October 14th 2019

Majority of Employers Are Willing to Increase Health, Wellness Budgets Compared With 10 Years Ago

Alison Rodriguez
Eighty percent of employers claimed that they are intending to increase their health and wellness budgets this year, more than double compared with 2009 (33%), according to results from the 10th annual Optum Wellness in the Workplace study.
Majority of Employers Are Willing to Increase Health, Wellness Budgets Compared With 10 Years Ago
October 14th 2019

Majority of Employers Are Willing to Increase Health, Wellness Budgets Compared With 10 Years Ago

Alison Rodriguez
Eighty percent of employers claimed that they are intending to increase their health and wellness budgets this year, more than double compared with 2009 (33%), according to results from the 10th annual Optum Wellness in the Workplace study.
Michael Thompson on Use of High-Deductible Health Plans
October 7th 2019

Michael Thompson on Use of High-Deductible Health Plans

High-deductible health plans have been popular, but it’s becoming clear they are not right for all employees, said Michael Thompson, president and chief executive officer of the National Alliance of Healthcare Purchaser Coalitions.
Health Benefits Survey Demonstrates Importance of Health Insurance Reform in 2020 Election Cycle
October 6th 2019

Health Benefits Survey Demonstrates Importance of Health Insurance Reform in 2020 Election Cycle

Alison Rodriguez
The 2019 Kaiser Family Foundation Employer Health Benefits Survey results revealed significant rises in annual premiums, setting the context for the role of health insurance reform during the 2020 election cycle.
Dr Thomas Parry Discusses How Benefit Designs Impact Employees Differently Based on Income
October 4th 2019

Dr Thomas Parry Discusses How Benefit Designs Impact Employees Differently Based on Income

Low-wage earners in a company face a larger burden in access to care compared with high-wage earners, but not all employers recognize this and design benefits with this in mind, said Thomas Parry, PhD, president and founder of the Integrated Benefits Institute.
Michael Thompson: Getting to a Value-Based Benefit Design
October 2nd 2019

Michael Thompson: Getting to a Value-Based Benefit Design

In the past few years, benefit designs have led to a reduction of both low-value and high-value care, and moving forward, new designs have to be tied more directly to value-based reimbursement, said Michael Thompson, president and chief executive officer of the National Alliance of Healthcare Purchaser Coalitions.
Michael Thompson on Promoting Use of High-Value Services Over Low-Value Ones
September 28th 2019

Michael Thompson on Promoting Use of High-Value Services Over Low-Value Ones

Employers have been talking about low-value care for years, but they’re trying to identify to remove the use of those services, said Michael Thompson, president and chief executive officer of the National Alliance of Healthcare Purchaser Coalitions.
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