While the Inflation Reduction Act of 2022 will likely improve member retention and curb healthcare costs for enrollees in the individual market, the impact on the employer market is less clear. As Medicare negotiates lower drug prices,...
In early 2020, fifteen healthcare leaders—spanning a wide range of backgrounds from government to industry to academia—converged for a little over a day to discuss a single, pressing issue that affected each of their fields:...
Most Americans reported that health insurers are not successfully deflecting high healthcare spending and many survey respondents sought more transparency and out-of-pocket healthcare spending support...
The Blue Cross Blue Shield Association (BCBSA) has partnered with a nonprofit generic drug company to help increase access to low-cost insulin for members living with diabetes.
Along with several...
Major payer organizations are reacting to payer-related aspects of the State of the Union address, including making permanent the American Rescue Plan Act premium subsidies and lowering drug...
Payers are reacting to the CMS proposed Medicare coverage determination for Alzheimer’s treatments that use monoclonal antibodies directed at amyloid, such as Biogen’s...
Updated 1/12/2022: This article has been updated to correct the drug price for Aduhelm. The article previously cited the drug price as the original price, which was $56,000. However,...
Prescription drug spending in the US drives healthcare spending primarily due to high US drug pricing, not necessarily because of the number of drugs that providers prescribe use, a Commonwealth Fund...
In 2021, prescription drug benefits took many forms as employers and payers played with tier structures and cost-sharing strategies to help manage prescription drug costs for employees, a Kaiser Family...
For certain diseases, some payers implement step therapy protocols that are stricter than clinical and regulatory entities have recommended, researchers found in a Health Affairs study.
“Step...
The Alliance of Community Health Plans (ACHP) is urging the federal government to take action and lower prescription drug prices with a set of recommended actions.
The costs of prescription drugs...
Purchaser Business Group on Health (PBGH) supported President Joe Biden’s plan to allow Medicare to negotiate drug prices.
“The truth is high drug costs are perpetuated by all parties...
Update 1/15/2021: This article has been edited to reflect that GoodRx included newly approved drugs in its calculations, which accounted for the change in the number of drugs that the...
CMS has released the final rule for price transparency in healthcare coverage, which aims to allow the public to have greater insight into healthcare costs in order to increase value.
“This...
High prescription drug spending has racked the American healthcare system’s cost trends for decades.
Prescription drug spending will be one of the major factors influencing the 2020 medical...
Update 03/03/2020: This article has been updated to reflect that Oscar Health might expand the number of options for migraine prescriptions. A previous version implied that there were no migraine...
Managed care organizations are providing Medicaid programs with lower cost prescription drugs, resulting in as much as $6.5 billion in net savings in fiscal year 2018, according to a recent report by...
While access to care progress has stalled nationwide, payers can continue to move it forward within their own businesses by addressing four key barriers.
Uninsurance is dropping, yet access to care...
CMS has proposed changes to Medicare Advantage that will increase plans’ revenues by 0.93 percent. The proposed rule would extend Medicare Advantage eligibility to those diagnosed with...
Price tags of life-saving treatments are continuing to increase, with nearly $150 billion being spent nationally per year for cancer care, four times more than treatment for other common health...
