Consumers Blame Payers, Utilization Management for Delays in Care
Consumers do not agree that insurers are protecting them from high out-of-pocket costs and find that utilization management practices—such as prior authorization and formulary...Humira Price for Commercial Plans Remained Steep Despite High Rebates
Despite increasing rebates, the net price of Humira for Medicaid and commercial health plans in 2020 remained high above the launch price, according to a study published in JAMA Network Open. The...How Mental and Behavioral Health Disparities Impact Adults, Youth
Mental and behavioral health disparities disproportionately impact racial minority groups, people with disabilities, and those who identify as lesbian, gay, or bisexual, a report from UnitedHealth...Medicare Advantage Plans Have Narrow Psychiatrist Networks, Study Finds
Psychiatrist networks in Medicare Advantage plans are narrower than those in Medicaid managed care and Affordable Care Act (ACA) plans, according to a study published in Health Affairs. As demand for...Unnecessary Utilization in CO Leads to $134M in Healthcare Spending
Updated 8/24/2023: This article has been updated to reflect that the share of healthcare spending on low value care was highest in commercial health plans. Previously, the article framed...Generic Insulin Drug Pricing, Access Still Pose Problems for Uninsured
Following up on a promise that Eli Lilly made in 2019, the offices of Senators Elizabeth Warren (D-MA), Richard Blumenthal (D-CT), and Raphael Warnock (D-GA) conducted a survey on the drug pricing and...10 Top-Selling Drugs Accounted for 22% of Medicare Part D Spending
The ten top-selling prescription drugs accounted for more than 20 percent of total gross Medicare Part D spending in 2021, a KFF analysis revealed. Under the Inflation Reduction Act’s Medicare...Sponsored by Real Time Medical Systems
