Payers

Humana's Bold Goal program allowed the health care giant to test new delivery models that it used to address loneliness and food insecurity during COVID-19.

Patients with acute myeloid leukemia (AML) who relapse after first-line treatment face a substantial health care resource utilization (HCRU) and cost burden, according to a poster presented at Virtual ISPOR 2021.

In the April Matters in Managed Care webinar, leaders from Anthem and a partner of Anthem’s Doula Pilot Program in California discuss how a health plan can take an active role in reducing disparities in maternity mortality, which has been recognized by the World Health Organization as a growing health concern in the United States.

In the April Matters in Managed Care webinar, leaders from Anthem and a partner of Anthem’s Doula Pilot Program in California discuss how a health plan can take an active role in reducing disparities in maternity mortality, which has been recognized by the World Health Organization as a growing health concern in the United States.

In the April Matters in Managed Care webinar, leaders from Anthem and a partner of Anthem’s Doula Pilot Program in California discuss how a health plan can take an active role in reducing disparities in maternity mortality, which has been recognized by the World Health Organization as a growing health concern in the United States.

In the April Matters in Managed Care webinar, leaders from Anthem and a partner of Anthem’s Doula Pilot Program in California discuss how a health plan can take an active role in reducing disparities in maternity mortality, which has been recognized by the World Health Organization as a growing health concern in the United States.

In the April Matters in Managed Care webinar, leaders from Anthem and a partner of Anthem’s Doula Pilot Program in California discuss how a health plan can take an active role in reducing disparities in maternity mortality, which has been recognized by the World Health Organization as a growing health concern in the United States.

In the April Matters in Managed Care webinar, leaders from Anthem and a partner of Anthem’s Doula Pilot Program in California discuss how a health plan can take an active role in reducing disparities in maternity mortality, which has been recognized by the World Health Organization as a growing health concern in the United States.

In the April Matters in Managed Care webinar, leaders from Anthem and a partner of Anthem’s Doula Pilot Program in California discuss how a health plan can take an active role in reducing disparities in maternity mortality, which has been recognized by the World Health Organization as a growing health concern in the United States.

In the April Matters in Managed Care webinar, leaders from Anthem and a partner of Anthem’s Doula Pilot Program in California discuss how a health plan can take an active role in reducing disparities in maternity mortality, which has been recognized by the World Health Organization as a growing health concern in the United States.

Technological innovation is helping to reinvent the traditional health economics and outcomes research (HEOR) field as traditional and new players partner to leverage data sources.

Expanded coverage under a Medicare-Medicaid partnership to treat all prevalent cases of hepatitis C appears to be cost-effective by saving money and improving patient outcomes.

Stakeholders identify the value elements of comprehensive genomic profiling (CGP) they find most important, as well as options for innovative contracts.

As the cost of therapies increases, US health plans are utilizing tools like step therapy, to ensure patients try cheaper alternatives first, and value assessment frameworks, to assist with the decision-making process.

With more than 3000 gene therapies in development, payers will have to grapple with the challenges of paying for these innovative but expensive therapies.

Sessions, posters, and late-breaking trials at the American College of Cardiology’s 70th Scientific Session offer updates on vericiguat, SGLT2 inhibitors, sacubitril/valsartan, and heart failure therapies still in the pipeline.

Two posters presented at Virtual ISPOR 2021 analyzed the health care resource utilization and cost of patients with chronic obstructive pulmonary disease (COPD) with pneumonia, as well as the cost savings of treating patients with frequent or severe COPD exacerbations with a fixed-dose triple therapy.

The COVID-19 pandemic brought together the world and taught health systems how to be resilient and adapt to both predictable and unpredictable changes, said the panelists during the plenary on day 1 of Virtual ISPOR 2021.

Two top cardiologists debated evidence involving one clinical trial for omega-3 fatty acids, with implications for another, the REDUCE-IT study for icosapent ethyl (Vascepa).

Results presented at the American College of Cardiology's 70th Scientific Session show most patients prefer a smaller dose and are more likely to stick with it.

When patients had the option of using prescription digital therapeutics, their insurers and employers saved significant money in both direct and indirect medical costs, the 2 studies found.

The 4-day annual meeting of ISPOR—The Professional Society for Health Economics and Outcomes Research—will cover a wide range of topics. Here are 5 themes to keep an eye out for.

Policy makers and health plans seek value-based management of specialty drugs. This study examines real-world factors that favor some approaches over others and their potential impact.

This study evaluates the cost-effectiveness and budget impact to US payers of point-of-care nucleic acid amplification tests (NAAT) for group A streptococcus.

On this episode of Managed Care Cast, Patricia Salber, MD, MBA, of The Doctor Weighs In, talks with the founder and CEO of ConsejoSano, a patient engagement firm working with diverse, multicultural, multilingual populations about the importance of building relationships and trust when trying to understand opinions and beliefs about COVID-19 vaccination.

Although most Medicare Part D plans cover guideline-recommended outpatient chronic obstructive pulmonary disease (COPD) inhalers, the utilization controls applied to these therapies vary by plan type.

Dupilumab is effective for atopic dermatitis, asthma, and chronic rhinosinusitis with nasal polyps, but a recent presentation noted the payer challenge in placing the biologic in an optimal tier.

William Shrank, MD, MSHS, the chief medical officer of Humana, discusses how the company is trying to overcome any vaccine hesitancy both in its workforce and in its insured member population.

A novel prediction model is developed that accurately predicts preterm birth in a timely manner among pregnant women in Medicaid without preterm-birth history.

In a review of literature published since the Affordable Care Act’s passage, more than half of analyses find that Medicare Advantage outperforms traditional Medicare on quality, health, and cost outcomes.