Tag Archives: ACA

Centene Looking for Growth Beyond WellCare

Centene Corp. announced that it will buy fellow Medicaid insurer WellCare Health Plans in an estimated $17.3 billion deal. When finalized, the two insurers would cover nearly 22 million people in Medicare, Medicaid and the ACA exchanges. Centene CEO Michael Neidorff will serve as chairman and CEO of the merged company. Centene’s shareholders would own […]

Designing Pharmacy and Medical Benefits for Cancer Care

Designing Pharmacy and Medical Benefits for Cancer Care: An Employer Perspective – published in Value-Based Cancer Care F. Randy Vogenberg, PhD, RPh, FASHP; Catherine E. Cooke, PharmD, BCPS October 2016, Vol 7, No 9 – Employers’ Perspective With the increasing complexity of cancer care after the passing of the 2010 Affordable Care Act, employers as […]

Insurers-Hospitals Face Cost Structure Change

Knowsource.com Announces Transition to Access Market Intelligence

Insurers-Hospitals Face Cost Structure Change Insurance fundamentals (risk) that supersede the ACA are driving changes seen in coverage, and at a more rapid pace each year, resulting from ACA impacts. One of those changes has been a significant increase in the use of alternate sites of care (ASOCs) due to medical policy changes driven by […]

Telehealth Applications Patient Care

Telehealth Applications Patient Care Rita M. Marcoux, RPh, MBA; F. Randy Vogenberg, PhD, RPh, FASHP June 2016, Vol 7, No 5 – Employers’ Perspective – Value-Based Cancer Care The term telehealth is used interchangeably with telemedicine by some organizations. However, telemedicine is typically associated with the delivery of traditional clinical diagnosis and monitoring by using […]

Oncology Biosimilars: Opportunity or Not?

Oncology Biosimilars: Opportunity or Not? VBCC – April 2016, Vol 7, No 3 – Employers’ Perspective F. Randy Vogenberg, PhD, RPh, Partner Access Market Intelligence Martha M. Rumore, PharmD, JD, MS, LLM, FAPhA The United States has the largest biologic drugs market and high prices for biologics, such as monoclonal antibodies, therapeutic proteins, immunomodulators, and […]

Impact of Commercial Insurance in 2017

Clinical trial collaborations – an idea whose time has come

Impact of Commercial Insurance in 2017 – Considerable attention and planning has been focused on the Medicare market, but as we see from the chart below, Medicare represents approximately 13% of the total population.   Employer 49% Medicaid 19% Medicare 13% Uninsured 10% Non-Group 6% Other Public 2% (Source: Kaiser Family Foundation) A recent Mercer […]

Health Benefits/Pricing Implosion

Health Benefits/Pricing Implosion – The announcement by the Obama administration that it would begin rating health insurance plans based on how many doctors and hospitals they include in their networks along with the announcement the ACA will now (2017) allow the individual deductible to increase to $7150 and $14,300 for family coverage will contribute to a pricing/benefit […]

Top Healthcare Market Trends

Knowsource.com Announces Transition to Access Market Intelligence

  Many of the 2016 top healthcare market trends began back in 2012-to-2014, and finally emerged more clearly in 2015 for commercially insured populations. This year Access Market Intelligence identifies four (4) major themes emerging that creates the top trends to watch in 2016 into 2017. Themes encapsulating the Top Trends are Macro Issues Trending […]