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October 24, 2016

Today's Featured Story

Deadline for Plans to Enter or Leave Exchanges Brings New Exits
Reprinted from Health Plan Week

More health insurers told the federal government by a Sept. 23 CMS deadline that they would not be participating in public exchanges for 2017, leaving Wall Street concerned those carriers left behind may absorb more sick and costly enrollees from exiting plans. At the same time, CMS on Sept. 27 unveiled a new program to entice younger and healthier millennials to the marketplaces as part of an outreach effort with the goal of avoiding adverse risk selection, which could chase even more insurers away the year after next.... Read Full Story


Quote of the Day

“America’s at a crossroads.... Scientific discovery has never been greater. The pipeline is full of great drugs [that are coming on the market at a fast pace]. But the challenge is they are coming out at prices never seen before. [In the U.S.] we are spending $400 billion per year on medication [and by 2018 that will increase to more than $500 billion]. Half of those drugs are consumed by people with rare and unmet needs.... There is a problem with sustainability.”

— Steve Miller, M.D. senior VP and chief medical officer for Express Scripts Holding Co., in opening remarks at his company’s Sept. 15 event in Washington, D.C., Solving for the Rising Cost of Complex Drugs.

Click here to read the SPECIALTY PHARMACY NEWS article in which this quote appeared — "Competition, Transparency Could Help Counter High Drug Prices" (Free for SPN subscribers; $17 for non-subscribers.)


Today's Datapoint

$58.9 million ... was paid in 2015 care coordination and shared-savings payments to physicians and hospitals by Horizon Blue Cross Blue Shield of New Jersey.



Today from Washington

People on the Move
TrialScope appointed Dan Lehman vice president of business development. He most recently led sales efforts for complex customer migrations at ViewPoint Construction Software....ContextMedia:Health named Adam Prowker senior vice president of marketing sciences. Previously, Prowker led the Epocrates analytics groups at athenahealth....Clinicient Inc. appointed T. Kent Rowe as CEO. Prior to joining Clinicient, Rowe served as senior vice president of sales at ZirMed.

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