While a new federal proposal to overhaul the prescription drug rebate system may not be a significant threat to major managed care companies’ bottom lines, insurers and PBMs alike are still not happy about it. Industry experts say that’s because insurers will likely have to raise Medicare Part D premiums in response, thus hurting their competitive advantage, and PBMs will be forced to rework their business models.

Even as some recent headlines have reignited concerns about the long-term prospects of the Affordable Care Act (ACA), the CEO of one of the health insurers that has benefited most from the law told investors that he continues to see more reasons to be optimistic than not.

CMS’s recent release of preliminary 2020 rate and policy information for Medicare plans indicates no major new policy proposals, and the agency’s proposed rate hike for plans seems neither excessively high nor worrisomely low, industry consultants and Wall Street analysts say.

by Carina Belles North Carolina this week awarded Medicaid contracts worth an estimated $6 billion per year to five managed care organizations: AmeriHealth Caritas; Blue Cross and Blue Shield of North Carolina; Carolina Complete Health, a provider-led subsidiary of Centene Corp.; UnitedHealthcare; and WellCare Health Plans, Inc. Centene was awarded a regional contract, and can […]