From The AIS Report on Blue Cross and Blue Shield Plans - In a recent Evercore ISI webinar, Howard Wild, vice president of generic strategies for pharmacy benefit manager (PBM) MedImpact, Inc., said the generic inflation rate has been “astronomical.…We’ve seen some drugs go up in excess of 2,000%,” he said, adding that price increases exceeding 100% “are not unusual.” And while the inflation eased up a bit at the beginning of 2015, it started going up again in April, although to a lesser degree. There are various reasons behind the generic drug price inflation. Read more
From Health Plan Week - Some health plans are going all out to flip the script on how they use data analytics to improve care management, which in turn could reduce costs and improve the coordination and medical status of their members, many of them in the high-risk, high-cost category. Innovators in this area include CareSource and Aetna Inc., among others, which have pushed ahead with new programs to identify and reach their customers. Read more
From AIS's Value-Based Care News - Regulators from the Federal Trade Commission (FTC) and the HHS Office of Inspector General (OIG) are signaling increased scrutiny of accountable care organizations and other value-based payment arrangements, especially those making “creative” use of the antitrust and fraud and abuse waivers in place for Medicare ACOs. Read more
From Medicare Advantage News - Capital BlueCross benefited from two programs CMS began in 2014 to help Medicare Advantage and stand-alone Prescription Drug Plan insurers emerge from marketing and enrollment sanctions, a plan executive said at the agency’s annual MA and PDP audit and enforcement conference in Baltimore June 16. In an unusual joint presentation with CMS’s top MA enforcement official, Todd Shamash, vice president, legal and regulatory affairs at the Blues plan, emphasized that… Read more
From Drug Benefit News - During a recent conference call to discuss the proposed acquisition of long-term care (LTC) pharmacy services provider Omnicare, Inc., CVS Health said it is focused on leveraging best practices to improve the coordination of pharmaceutical care for Medicare Part D patients as they transition between health care settings. Read more
From Specialty Pharmacy News - The merger-and-acquisition (M&A) activity within the pharmacy sector continues, with CVS Health Corp. leading the way. And at least one industry expert maintains that there’s no reason to expect a slowdown. On May 21, CVS said it had agreed to buy Omnicare, Inc. for $12.7 billion. The deal includes not only its long-term care (LTC) business but also the Omnicare Specialty Care Group, which consists of specialty pharmacy Advanced Care Scripts… Read more
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