From Drug Benefit News - Narrow pharmacy networks are becoming more commonplace throughout the market, as plan sponsors realize they can reduce prescription drug costs through improved dispensing fees and other discounts with little member disruption. But in order to successfully implement a narrow or tiered network, plans must deploy a varied communication strategy with both members and providers, advised three pharmacy experts during the Aug. Read more
From Health Plan Week - Venture capital is flowing into the digital health space at rates that by midyear 2014 had already eclipsed what was seen for all of last year, according to new industry data. That leaves health insurers to consider investments in or outright acquisitions of a bevy of software developers, wearable device makers and behavioral health tool creators. Sifting through the suddenly crowded digital health startup market has become an important part… Read more
From ACO Business News - Most accountable care organizations have a health information technology (HIT) infrastructure that can support relatively simple activities, such as quality measurement and physician payment. Read more
From Medicare Advantage News - Despite persistent and varied efforts by CMS to foster their spread, less than half of Medicare Part D enrollees eligible for medication therapy management programs receive them, and only 11% of all Part D enrollees were part of MTM programs in 2012, according to a new study of CMS data from that year by consulting firm Avalere Health LLC. Moreover, Avalere found that just 1% of Part D enrollees in… Read more
From Drug Benefit News - When it comes to targeting patients for medication adherence interventions, many health plans continue to rely on pharmacy claim “triggers” such as a prescription not being picked up and retrospective adherence measures such as a medication possession ratio below 80% for a certain period of time. But only 7% of plans recently surveyed by AllazoHealth are using the newer method of predictive analytics to prioritize patients at risk of not… Read more
From Report on Medicare Compliance - It wasn’t that Brookdale Senior Living didn’t screen its employees for exclusion from federal health care programs. But until mid-2013, the chain of senior living communities wasn’t using the gold standard — Social Security numbers — to do it, and an excluded employee slipped by, according to the HHS Office of Inspector General (OIG). In late July, Brookdale paid $353,248 to settle allegations that it violated the civil monetary penalty… Read more
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