Health Plan Business

From Health Plan Weekly - Blue Cross and Blue Shield plans might move to adopt unique outcomes-based payment strategies, as new immunotherapy drugs and therapies to treat non-alcoholic steatohepatitis (NASH) pose more cost-control issues. FDA approved the first chimeric antigen receptor (CAR) T-cell therapy, Kymriah, in 2017, under which immune cells are removed from a patient, altered genetically and then transfused back in. A one-time treatment costs $475,000. “CAR-T is a really, really big-ticket item,” says Eric Estes, R.Ph., senior director, pharmacy services for Independence Blue Cross (IBC). Read more

From Health Plan Weekly - Blues plans in Michigan, Tennessee and other states are testing new strategies to combat opioid addiction in their regions, even as President Trump signed the spending bill that releases new funds to fight the crisis. As overdose deaths in Michigan involving prescription opioids have tripled since 2012, Blue Cross Blue Shield of Michigan has a commitment from the top down. Read more

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