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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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Percentage of Private-Sector Employers With at Least One Self-Insured Health Plan Has Decreased
September 23rd 2019

Percentage of Private-Sector Employers With at Least One Self-Insured Health Plan Has Decreased

Alison Rodriguez
While the number of employers who reported they had self-insured at least one health plan had increased from 1999 to 2016, there was a sharp decrease by 38.7% in 2018, according to research from the Employee Benefit Research Institute.
Michael Thompson: Employers Are Grappling With High Costs of Novel Therapies
September 19th 2019

Michael Thompson: Employers Are Grappling With High Costs of Novel Therapies

Novel therapies come with high costs, but they have the potential to more effectively treat some patients, and employers are struggling to handle the cost burden of them, said Michael Thompson, president and chief executive officer of the National Alliance of Healthcare Purchaser Coalitions.
Exploring Reference-Based Pricing as a Method for Lowering Healthcare Costs
September 18th 2019

Exploring Reference-Based Pricing as a Method for Lowering Healthcare Costs

Reference-based pricing has been touted as a way to contain healthcare costs while ensuring quality of care. We talk with with David Henka, chief executive officer of ActiveRADAR, to dig deeper into how the method is used in practice and what program results have shown.
Nearly 75% of US Hospital Markets Highly Concentrated, HCCI Report Shows
September 17th 2019

Nearly 75% of US Hospital Markets Highly Concentrated, HCCI Report Shows

Allison Inserro
The Health Care Cost Institute (HCCI) Tuesday released their final Healthy Marketplace Index, which also showed that 69% of markets studied showed an increase in concentration.
Wasteful Drug Spending Contributes to High Prescription Costs
September 15th 2019

Wasteful Drug Spending Contributes to High Prescription Costs

Alison Rodriguez
Up to 12% of pharmacy spending may be on high-cost, low-value drugs that can be removed from formularies.
Employers Recognize Need to Improve Employee Health Experience
September 8th 2019

Employers Recognize Need to Improve Employee Health Experience

Alison Rodriguez
Employers are recognizing the need to modernize the employee health experience following research that demonstrates the disconnect between companies’ investment in health benefits and the impact on employee health.
Michael Thompson Highlights Employer Efforts to Address Mental Health Issues
September 8th 2019

Michael Thompson Highlights Employer Efforts to Address Mental Health Issues

Employers have become more aware of how key an issue mental health is for employees and they are relieving some of the perceived stigma by making it okay to talk about mental health issues, said Michael Thompson, president and chief executive officer of the National Alliance of Healthcare Purchaser Coalitions.
Michael Thompson on Employers Engaging on Value-Based Reimbursement
September 4th 2019

Michael Thompson on Employers Engaging on Value-Based Reimbursement

Currently, employers choose health plans based on administrative costs and provider discounts, but they need to start engaging around value-based reimbursement, said Michael Thompson, president and chief executive officer of the National Alliance of Healthcare Purchaser Coalitions.
What's Gone Astray in American Healthcare and Pricing
September 4th 2019

What's Gone Astray in American Healthcare and Pricing

On this episode of Managed Care Cast, we speak with the author of a new book that discusses the price and cost of American healthcare. Martin Makary, MD, MPH, a surgical oncologist and chief of the Johns Hopkins Islet Transplant Center, talked about what he found while writing The Price We Pay: What Broke American Health Care—and How to Fix It. Makary discusses spurious billing practices, overtreatment, and the opioid issue, as well as efforts by some providers and employers to reshape primary care.
Out-of-Network Billing Continues to Increase and Creates Financial Strain, Study Finds
September 3rd 2019

Out-of-Network Billing Continues to Increase and Creates Financial Strain, Study Finds

Alison Rodriguez
Out-of-network billing continues to become more common for patients with private insurance even when seeking treatment at in-network hospitals, which creates a financial strain for many patients, according to study results published by JAMA Internal Medicine.
Michael Thompson Discusses Value-Based Care Among Employers
August 28th 2019

Michael Thompson Discusses Value-Based Care Among Employers

Employers are looking for ways to advocate for their employees and invest in places that will reduce downstream costs, said Michael Thompson, president and chief executive officer of the National Alliance of Healthcare Purchaser Coalitions.
Healthcare Costs Increased Twice as Fast as Worker Wages Over Last Decade
August 26th 2019

Healthcare Costs Increased Twice as Fast as Worker Wages Over Last Decade

Alison Rodriguez
As health costs continue to increase, health spending by families with large employer health plans has increased 2 times faster than workers’ wages over the last 10 years.
Podcast: This Week in Managed Care—BRCA Testing Recommendation and Other Health News
August 25th 2019

Podcast: This Week in Managed Care—BRCA Testing Recommendation and Other Health News

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.
This Week in Managed Care: August 23, 2019
August 23rd 2019

This Week in Managed Care: August 23, 2019

This week in managed care, the top news included outcomes results in treating heart failure; US prevention experts said more women should get BRCA testing; the American Heart Association offered an advisory on treating high triglycerides with prescription omega-3 fatty acids.
Costs, Quality, Access, and More: The Challenges of Providing Healthcare to Employees
August 20th 2019

Costs, Quality, Access, and More: The Challenges of Providing Healthcare to Employees

Business leaders discuss challenges of providing healthcare to employees and what has changed in the last few years.
Community Health Associated With Emergency Department Use, Study Finds
August 19th 2019

Community Health Associated With Emergency Department Use, Study Finds

Alison Rodriguez
Study authors suggested that future research involve developing and testing strategies for business investment in building healthier communities.
How Are Oncology Practices Communicating Value-Based Care to Employers and Patients?
August 14th 2019

How Are Oncology Practices Communicating Value-Based Care to Employers and Patients?

On this episode of Managed Care Cast, we’re bringing you a portion of a panel discussion about the Oncology Care Model, held in July 2019 during a meeting of The Institute for Value-Based Medicine® (IVBM), an initiative of The American Journal of Managed Care®. At IVBM events, we gather thought leaders to share best practices across medicine, pharmacy, and management in regional locations around the country. This podcast is taken from our meeting focusing on Innovation and Quality in Oncology Care.
With Cutting-Edge Benefits Come Bioethical Challenges
August 13th 2019

With Cutting-Edge Benefits Come Bioethical Challenges

Suzanne Delbanco, PhD, MPH
As disruptive medical technologies emerge, often unanticipated, bioethical issues arise, presenting challenges for employers navigating what benefits to offer to their employees.
Trump Administration Publishes Final Rule Aimed at Legal Immigrants Using Public Benefits
August 12th 2019

Trump Administration Publishes Final Rule Aimed at Legal Immigrants Using Public Benefits

Allison Inserro
The Department of Homeland Security said that it was promoting the ideals of self-sufficiency, self-reliance, industriousness, and perseverance, but it also acknowledged that the vast majority of the 266,000-plus commenters on the rule opposed the change and noted that some people may decide to drop out of benefit programs.
Asthma Adversely Affects Time Spent at Work, Study Finds
August 9th 2019

Asthma Adversely Affects Time Spent at Work, Study Finds

Alison Rodriguez
Asthma adversely affects the everyday lives of many individuals regardless of long-term maintenance medication, according to a study evaluating the association of time spent at work and adverse asthma effects.
Lauren Vela: Unity Is Vital in the Transition Toward Value-Based Care
August 6th 2019

Lauren Vela: Unity Is Vital in the Transition Toward Value-Based Care

Division among employers prolongs their inability to alter the healthcare system, but by acting together, value-based care will begin to spark change, said Lauren Vela, MBA, senior director, Member Value, Pacific Business Group on Health.
Number of Families Enrolling in Public Insurance Continues to Increase, Study Finds
August 5th 2019

Number of Families Enrolling in Public Insurance Continues to Increase, Study Finds

Alison Rodriguez
The number of families enrolling their children in Medicaid or the Children’s Health Insurance Program continues to increase, emphasizing the need for policies to recognize the role of public insurance as costs for private insurance continue to grow, according to a study published in Health Affairs.
Coordinated Wellness Strategy Nets Positive Results and Savings at The Ohio State University
August 2nd 2019

Coordinated Wellness Strategy Nets Positive Results and Savings at The Ohio State University

Laura Joszt, MA
A case study from The Ohio State University highlights how initiatives addressed system-level drivers of burnout and not only improved the health of faculty, staff, and students, but also saved money.
Financial Burden of Medicare Is Increasing as Employer Coverage Erodes for Retired Seniors
August 1st 2019

Financial Burden of Medicare Is Increasing as Employer Coverage Erodes for Retired Seniors

Sara Karlovitch
Low- and middle- income Medicare beneficiaries face increasing financial burden as employer coverage erodes.
Health-Related Absenteeism Another Measure of Influenza's Reach, CDC Report Says
July 26th 2019

Health-Related Absenteeism Another Measure of Influenza's Reach, CDC Report Says

Alison Rodriguez
Health-related workplace absenteeism may provide additional information about the extent of influenza sickness in the working-age population, a CDC report said.
Vanessa Sammy Outlines Successful Healthcare Partnerships and Improving Transparency
July 25th 2019

Vanessa Sammy Outlines Successful Healthcare Partnerships and Improving Transparency

Successful partnerships between employers and healthcare organizations need trust and transparency, said Vanessa Sammy, MPA, MHSA, senior director of commercial strategy and implementation for Remedy Partners.
Workplace Health Program Participation Linked to Sociodemographics and Other Factors
July 24th 2019

Workplace Health Program Participation Linked to Sociodemographics and Other Factors

Alison Rodriguez
The participation in workplace health promotion programs (WHPPs) varies depending on sociodemographics and occupation, suggesting the need for employers to adjust their WHPPs for maximum participation, according to research.
Designing Valuable Benefits Means Understanding the Population
July 18th 2019

Designing Valuable Benefits Means Understanding the Population

Laura Joszt, MA
Panelists at the National Alliance of Healthcare Purchaser Coalitions' Leadership Summits highlighted the ways their companies are customizing care and benefits to meet the needs of their employees.
Cadillac Tax Would Impact 1 in 5 Employers Who Offer Coverage
July 17th 2019

Cadillac Tax Would Impact 1 in 5 Employers Who Offer Coverage

Jaime Rosenberg
If the High-Cost Plan Tax, also known as the Cadillac tax, goes into effect in 2022, 21% of employers who offer coverage would be impacted, and that percentage would increase fairly rapidly by 2030.
Exercise Intervention May Reduce Risk of Metabolic Diseases and Improve Work Productivity
July 12th 2019

Exercise Intervention May Reduce Risk of Metabolic Diseases and Improve Work Productivity

Alison Rodriguez
An exercise-focused intervention may be effective for improving mental health, work ability, and productivity outcomes while reducing metabolic syndrome severity for individuals at a high risk for cardiovascular and metabolic disease, according to researchers.
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