UnitedHealthcare Adds Deductibles to Medicare Part D for 2025
Oct 3, 2024 · UnitedHealthcare is adding deductibles to Part D prescriptions on certain formulary tiers as a result of plan design changes from the Inflation Reduction Act.
Aetna Updates MA and Drug Programs for Medicare in 2025
Oct 1, 2024 · In 2025, Aetna, the health insurance company of CVS Health, has added several new programs to Medicare for 2025. Aetna will launch new Chronic Condition Special Needs Plans (C-SNPs) in Illinois (Chicago) and Pennsylvania (Philadelphia and Pittsburgh).
Lilly Introduces Zepbound Single-Dose Vial for Cash-Paying Patients
Aug 27, 2024 · “In a clinical study, the 5 mg maintenance dose helped patients achieve an average of 15% weight loss after 72 weeks of treatment and has been a powerful tool for millions of people with obesity looking to lose weight and keep it off,” Patrik Jonsson, executive vice president, and president of Lilly Cardiometabolic Health and Lilly USA, said in a news release.
How Capitation Contracts Benefit Providers, Payers and Patients
May 11, 2023 · The Covid-19 pandemic triggered a dramatic decline in patient volume that devastated revenues for provider organizations operating under the fee-for-service (FFS) reimbursement model. In response, more provider organizations have adopted alternative payment models (APM) built around financial incentives to efficiently deliver high-quality care.
Beyond the Big Three PBMs - Managed Healthcare Executive
Dec 19, 2022 · By almost any measure, the PBM business is one dominated by the major players. In 2021, CVS Caremark led the industry, controlling 34% of total adjusted claims, followed by Express Scripts (25%) and Optum Rx (21%).
Evernorth is “Foundational” to Cigna’s Business
Feb 2, 2024 · The Cigna Group’s 2023 revenue grew to $195.3 billion, up 8% compared with 2022’s revenue of $180.6 billion. In the fourth quarter of 2023, Cigna’s revenue was up 12%, which company officials said in an earnings call reflects strong growth at both Evernorth Health Services and Cigna Healthcare.
Managed Healthcare Executive
Managed Healthcare Executive provides C-suite executives at health plans and provider organizations with news, analysis, insights, and strategies to pursue value-driven solutions.
Gain a solid understanding of compendia and its impact on …
Jul 1, 2012 · The current compendia landscape, through constantly in flux, impacts everything from payer approval of off-label use to manufacturer patient access initiatives. Drug compendia, defined as summaries of drug information, affects coverage and reimbursement decisions for pharmaceuticals products, and as a result, it's important for pharmaceitucal manufacturers and healthcare providers to ...
FDA Approves First Anti-inflammatory Drug for Cardiovascular …
Jun 20, 2023 · “To treat coronary disease effectively, cardiologists must aggressively reduce inflammation and cholesterol. For appropriate patients already taking a statin, adding the anti-inflammatory drug colchicine at a dose of 0.5 mg daily has been proven to significantly lower risks of recurrent heart attack and stroke,” lead author of The Lancet paper Paul Ridker, M.D., MPH, professor of medicine ...
The Leap to Self-Insurance - Managed Healthcare Executive
Jun 4, 2024 · Health insurance, like any insurance, is about pooling risk and paying premiums to create some financial cushion against costly events. For years, though, many large employers — what constitutes large means varies, but it’s typically 500 or more employees — have self-insured, meaning they have taken on the responsibility of setting funds aside to pay healthcare claims instead of a health ...