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November 28, 2017
Hot Topic
With rumors swirling that CVS Health Corp. is in talks to purchase Aetna Inc., merger-and-acquisition activity in the PBM industry is heating up. Here’s a look at recent deals.
In a move that pulls pharmacy benefits management together with broader medical benefits management, Express Scripts Holding Co. has reached an agreement to acquire privately held eviCore healthcare for $3.6 billion...
After 22 months of negotiations and wrangling with the FTC, Walgreens Boots Alliance, Inc. scaled back its original plan to purchase Rite Aid Corp....
Magellan Health, Inc. says it will acquire privately held PBM Veridicus Holdings, LLC for $74.5 million....
Today's AIS Health Datapoint
Four of the top 10 largest Dual-Eligible Special Needs Plans (D-SNPs) in the country are operated by UnitedHealthcare. A total of 549,462 duals are currently enrolled in the insurer’s D-SNP offerings.
AIS's Medicare and Medicaid Market Data: Enrollment, Premium Rates, Benefit Designs and Strategies of Medicare and Medicaid Plans

Quote of the Day
“Our providers were already trying to go down this path. Yet…we’ve seen very stale progress because each plan is trying to negotiate some unique value-based payment structure, not really making it at a system level. So we said, ‘Let’s use the role of [the] state in getting the entire market to a very specific set of upside-downside delivery system models, [and] have our plans and providers come together to compete on how well they actually do the care delivery behind that.’”
— Dan Tsai, director of the MassHealth Massachusetts Medicaid program, said during a Sept. 27 session of the America’s Health Insurance Plans National Conference Medicaid in Washington, D.C., describing his state’s efforts to move to value-based care.

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