AIS's Health Business Daily
Strategic Business News from Experienced Health Care Reporters
at Atlantic Information Services, Inc.
Medicare Advantage News
Today’s issue is brought to you by AIS's Medicare Advantage News, biweekly news and analysis on the Medicare (and Medicaid) managed care programs.

April 18, 2014

Today's Featured Story

Adopted ‘Doc Fix’ Bill Includes Just One-Year Extension for Special Needs Plans
Reprinted from Medicare Advantage News

The Medicare Advantage Special Needs Plan industry won another one-year extension — this time through the end of 2016 — in the “doc fix” legislation passed by the Senate March 31 after earlier being passed by the House .... Read Full Story

 

Quote of the Day

“Costs will go through the roof if there isn’t someone to help members understand what their options are and advise physicians what options they have [with regard to specialty drugs]. With specialty pharmacy, it’s $3,000 on average per script compared with $30 for generics. Payers need to be thinking very carefully about how to manage their plan design, [including] what is the right cost share, when it’s appropriate to put prior authorization in place, [whether they want to use] step edits — what are appropriate formulary tools, essentially.”

— Sumit Dutta, M.D., senior vice president and chief medical officer at Catamaran Corp.

Click here to read the DRUG BENEFIT NEWS article in which this quote appeared. (Free for DBN subscribers; $17 for non-subscribers).

 

Today's Datapoint

Only about
20% … of the “additional” payment that Medicare Advantage plans get versus Medicare fee-for-service winds up being “passed through to consumers in the form of better coverage,” according to a new working paper by three University of Pennsylvania Wharton School researchers published by the National Bureau of Economic Research.

Click here to read the MEDICARE ADVANTAGE NEWS article in which this datapoint appeared. (Free for MAN subscribers; $17 for non-subscribers).

 

Today from Washington

People on the Move

VLP Therapeutics, Inc. named Ryuji Ueno, M.D., chair and chief medical officer. Ueno was chair, CEO and chief scientific officer at Sucampo Pharmaceuticals, Inc...3M Drug Delivery Systems appointed Cindy Kent president and general manager. She succeeds James Ingebrand, who was named president and general manager of 3M ESPE, 3M’s dental division. Kent was vice president of strategy, business development and U.S. medical accounts for 3M Healthcare.

 

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