AIS's Health Business Daily is a daily email newsletter with strategic business stories written by experienced AIS Health reporters, as well as other information of interest to health care business leaders — including news from the nation’s leading health insurers, developments from the federal and state governments that impact the health care industry, and exclusive datapoints from Subscribe now to get an issue delivered to your inbox every morning!
September 26, 2017
Hot Topic
In an effort to help reduce the flow of opioids to those at risk of addiction, insurers are balancing the need to reduce pharmacy access while still ensuring availability to those who need the powerful painkillers. Here’s a look at recent developments.
The opioid crisis reached a new level of concern when President Donald Trump responded to recommendations from a White House panel chaired by New Jersey Gov. Chris Christie (R) to declare it a national emergency...
As congressional Republicans seek to repeal and replace the Affordable Care Act, funding of resources to combat the nation’s growing opioid epidemic has become part of the debate among lawmakers...
The goal of Anthem, Inc.’s Pharmacy Home Program (PHP) is to keep members out of it...
Today's AIS Health Datapoint
352,010 ... is the number of people enrolled in Kaiser Permanente Senior Advantage in California, the nation's largest Employer Group Waiver Plan (EGWP).
AIS's Medicare and Medicaid Market Data: Enrollment, Premium Rates, Benefit Designs and Strategies of Medicare and Medicaid Plans

Quote of the Day
“The formulary started as a clinical tool, but for most PBMs it has really become a vehicle for market share manipulation. While it may deliver some financial value to PBM clients, it is not really a ‘value-based’ approach.”
— Josh Golden, area senior vice president at Solid Benefit Guidance (a division of Arthur J. Gallagher & Co.), tells Drug Benefit News he “takes issue” with some PBMs expanding the definition of value-based pricing to include formulary exclusions.

The Featured Story of the day may be accessed on the day it is transmitted without logging in to Thereafter, you may need to log in to access the Featured Story. If you haven’t yet registered on, please take a minute to create a free account now and get free access to thousands of articles, blogs and much more.

Questions or suggestions about the content in AIS's HEALTH BUSINESS DAILY should be directed to Executive Editor Jill Brown at

AIS's HEALTH BUSINESS DAILY is copyrighted and protected by federal law. The re-use of its content is restricted (see below). However, you are permitted to forward this email to as many of your friends and colleagues as you wish, or better yet have them sign up for their own copy at atlantic_subscription.cfm

Copyright © 2017 Managed Markets Insight & Technology, LLC. All rights reserved. It is not permissible to include all or any portion of this content on any Web site, intranet or electronic network or in any print publication, without AIS's written permission in advance. Permission requests should be directed to