Payers

The administration said it would make the results of its drug price negotiations with manufacturers, as well as its approach to value-based care models, open to a variety of payers.

On this episode of Managed Care Cast, we speak with one of the authors of a recent book looking at the erosion of trust in health care, the factors that influence trust, and what can be done to restore trust.

On January 1, CMS implemented the Hospital Price Transparency final rule, but by July, it was clear that many hospitals were noncompliant. Even with a proposed rule for penalties, requirements still only fall on certain parts of the health care industry.

The chief of medical oncology and hematology at Bryn Mawr Hospital and associate principal investigator for Main Line Health's NCI Community Oncology Research Program discusses therapeutic advances along with ongoing challenges in enrolling patients with small cell lung cancer (SCLC) in clinical trials.

Gaucher disease is a rare metabolic condition that causes a fatty substance to build up in the organs and bones. Patients can suffer liver enlargement, anemia, and reduced platelets; they experience fatigue, bone infarctions, and permanent disability or death.

Polypharmacy may be raising the risk of inappropriate medication use, and avoiding this is crucial.

The approval of zanubrutinib makes it just the second therapy indicated for this rare type of lymphoma.

This article provides a description of prospective financial simulation methodology and use cases with empirical data for episode-based bundled payments, including implications for contract negotiations and value-based care redesign.

A review of therapies for atopic dermatitis (AD) found adequate net health benefit for new treatments. However, safety remains a concern for the Janus kinase (JAK) inhibitors.

The pandemic has shown a spotlight on how critically important respiratory care is to Americans who struggle to breathe on their own. Yet, Medicare policy must be updated to ensure that access to lifesaving equipment will never be disrupted.

Schizophrenia, chronic pain, and multiple medical diagnoses at enrollment into a large managed Medicaid system are associated with long-term high health care utilization.

Late July brings a 64% enrollment increase; owner charged with fraudulently billing Medicare over $784 million; COVID-19 hot spots lose nurses due to burnout.

In the June Matters in Managed Care webinar, experts from Blue Cross and Blue Shield of North Carolina, Duke-Margolis Center for Health Policy, UNC Center for the Business of Health, and WakeMed discussed how they are working together to address some of the state’s unique primary care needs.

In the June Matters in Managed Care webinar, experts from Blue Cross and Blue Shield of North Carolina, Duke-Margolis Center for Health Policy, UNC Center for the Business of Health, and WakeMed discussed how they are working together to address some of the state’s unique primary care needs.

In the June Matters in Managed Care webinar, experts from Blue Cross and Blue Shield of North Carolina, Duke-Margolis Center for Health Policy, UNC Center for the Business of Health, and WakeMed discussed how they are working together to address some of the state’s unique primary care needs.

In the June Matters in Managed Care webinar, experts from Blue Cross and Blue Shield of North Carolina, Duke-Margolis Center for Health Policy, UNC Center for the Business of Health, and WakeMed discussed how they are working together to address some of the state’s unique primary care needs.

In the June Matters in Managed Care webinar, experts from Blue Cross and Blue Shield of North Carolina, Duke-Margolis Center for Health Policy, UNC Center for the Business of Health, and WakeMed discussed how they are working together to address some of the state’s unique primary care needs.

In the June Matters in Managed Care webinar, experts from Blue Cross and Blue Shield of North Carolina, Duke-Margolis Center for Health Policy, UNC Center for the Business of Health, and WakeMed discussed how they are working together to address some of the state’s unique primary care needs.

In the June Matters in Managed Care webinar, experts from Blue Cross and Blue Shield of North Carolina, Duke-Margolis Center for Health Policy, UNC Center for the Business of Health, and WakeMed discussed how they are working together to address some of the state’s unique primary care needs.

In the June Matters in Managed Care webinar, experts from Blue Cross and Blue Shield of North Carolina, Duke-Margolis Center for Health Policy, UNC Center for the Business of Health, and WakeMed discussed how they are working together to address some of the state’s unique primary care needs.

Speakers at the Advanced Topics for Oncology Pharmacy Professionals Summit discussed financial toxicity in health care, how it particularly impacts patients with cancer, and how to address the issue with patients and the health system.

The federal government requires insurers to cover PrEP; Johnson & Johnson (J&J) and pharmaceutical wholesalers agree to settle opioid crisis lawsuits; NYC health care workers will be required to receive a vaccine or weekly tests for COVID-19.

Members covered by an integrated pharmacy benefit (as opposed to a pharmacy carve-out) experienced slower growth in medical spending.

In this episode of Managed Care Cast, the lead author of an article in the July issue of The American Journal of Managed Care describes the latest research that looks at the power of self-insured employers to negotiate hospital prices and the relationship between employer market power and hospital prices.

Larger primary care practices in downside risk–only payment models and capitation saw the highest telemedicine utilization rates by their patients enrolled in Medicare Advantage (MA) plans.

A string of controversies surrounding the approval of Biogen's Alzheimer disease drug aducanumab (Aduhelm) has not only called into question the independent nature of the FDA, but puts both providers and patients in a challenging position when it comes to deciding whether or not to prescribe or take the treatment.

This study examines the ability of self-insured employers to negotiate hospital prices and the relationship between hospital prices and employer market power in the United States.

PBMs keep copays higher on the same generic drugs.

Robin Gelburd, JD, details the dip in telehealth claims observed during April 2021.

The Medicare Access and CHIP Reauthorization Act (MACRA) needs to be reimagined get back on track and to live up to its promise to incentivize value-based care.