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From Drug Benefit News - Armed with data from a pair of studies, Prime Therapeutics LLC is approaching manufacturers to see if they’d be willing to enter into innovative new contracts with the PBM. Drilling down on data such as whether use of a drug follows its indication and how the conditions that drugs are treating break down can help with managing some high-cost specialty drugs in particular. Read more

From Health Plan Week - Health insurance rates in the group market have remained relatively stable over the past several years. However, little has been done to impact the cost of medical care, and employers in 2017 will push health insurers for more savings. As the economy has grown more robust, employers are looking to grow their business and want to rein in employee benefit costs, says Cary Badger, a former Regence Group executive who is… Read more

From The AIS Report on Blue Cross and Blue Shield Plans - As the dominant players on many state health insurance exchanges, Blue Cross and Blue Shield plans are particularly vulnerable to negative financial conditions on the marketplaces. But Blues plans (excluding publicly traded Anthem, Inc. Read more

From Medicare Advantage News - In a preliminary look at the outcome of the recently concluded Medicare Advantage Annual Election Period (AEP), observations gathered from marketing experts indicate that shopping among MA and Part D consumers was active but that enrollees were slow to pull the trigger on narrowing down a plan. This could have been due to a variety of factors, from overall concerns about the cost and complexity of benefits to “noise” surrounding… Read more

From Drug Benefit News - Health Care Service Corp. (HCSC) is enlisting pharmacists at four supermarket chains in five states to help improve medication adherence rates in its Medicare Advantage, Part D and dual-eligible populations with diabetes, hypertension and high cholesterol. Read more

From Report on Medicare Compliance - The pioneering treatment at your hospital, where surgeons are injecting adenoviruses and retroviruses into glioblastoma brain tumors to induce an anti-tumor immune response, may not seem like something that belongs on your compliance risk assessment, but biosafety isn’t just about reducing risk from infectious diseases and hazardous materials. It also requires oversight of emerging gene therapies. Read more

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