Pharmacy Benefits Management

September 18, 2014 | Anthony Brino

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.

September 10, 2014 | Anthony Brino

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.

September 8, 2014 | Anthony Brino

The currents of health reform and consumerization are getting more treacherous for incumbent hospital businesses, but payers and retailers, especially, have waves to ride.

September 4, 2014 | Anthony Brino

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.

August 19, 2014 | Anthony Brino

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.

August 14, 2014 | Anthony Brino

A once-promised truth in pharmaceutical benefits management is unravelling, leaving payers exposed and researchers scratching their heads.

August 12, 2014 | Anthony Brino

Amid challenging trends in drug prices and formularies, independent pharmacy advocates are pushing for a new "any willing" provider mandate in Medicare Part D.

July 15, 2014 | Anthony Brino

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.

July 7, 2014 | Anthony Brino

The growth of total U.S. medical costs is slowing down, but one segment is expanding fast enough to catch insurers by surprise.

June 17, 2014 | Anthony Brino

Pressure is growing on insurers to stop using mail-order pharmacies for speciality medications, and also on benefits managers to find new ways to get lower drug prices.

June 12, 2014 | Anthony Brino

Sovaldi has brought high prices of specialty drugs to the fore. Less examined so far are proactive approaches insurers and drug benefits managers can use to curb the growth trend without sacrificing quality or access.

May 27, 2014 | Charles Ornstein, ProPublica

The federal government has granted itself potent new authority to expel physicians from Medicare if they are found to prescribe drugs in abusive ways, following through on a proposal issued earlier this year.


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