Cost-sharing in traditional Medicare is on the rise, and benefit designs in Medicare drug plans are changing.
The new hepatitis C treatment Sovaldi has driven debate over drug costs for close to a year, but it’s also been a case study in access and coverage in public payer programs.
Drug benefits stand as some of the most consequential consumer confusions that can arise in public exchanges, increasing the onus on insurers to improve the design and explanation of formularies.
A shrinking number of Medicare Part D drug plans is set to bring beneficiaries some more low-cost choices, but also some potentially confusing benefit designs.
Struggling Medicare Advantage and Part D drug plans are being given a last minute reprieve, although they will need to show more improvement if they want to stay alive longer than a year.
UnitedHealth Group's big data venture is plying new waters in deals with several powerful healthcare institutions, trying to create value with one of healthcare's largest databases.
The currents of health reform and consumerization are getting more treacherous for incumbent hospital businesses, but payers and retailers, especially, have waves to ride.
The pharmacy benefits industry is challenging a new state law, trying to protect a key management tool that insurers, employer groups and public payers have been relying on for cost stability.
Insurers may need to find new ways to control costs for specialty drugs, as more states add limits to cost-sharing and utilization continues to grow.
A once-promised truth in pharmaceutical benefits management is unravelling, leaving payers exposed and researchers scratching their heads.
Amid challenging trends in drug prices and formularies, independent pharmacy advocates are pushing for a new "any willing" provider mandate in Medicare Part D.
Evidence from recent federal enforcement actions suggest pharmacy benefit managers are exposing public-payer managed care plans to problems that could send shivers up executive's spines.
Who moves first in price transparency, providers or payers?
Small businesses looking for greener benefits pastures
Providers mull risks, benefits of launching health plans
Co-op looks beyond FFS from get-go
A good night's sleep as untapped market
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