Tag Archives: CMS

Trusts, Busting (Telehealth and Rx Blooming?)

Last week, the Social Security and Medicare boards of trustees released their annual financial forecasts, and media reports predictably led with their scariest interpretation of those forecasts: “Hospital fund set to run out by 2026” read one typical headline. The trustees have a long-established track record of, well, let’s call it “conservative” forecasting, and nothing […]

States Begin to Take Action Against Copay Accumulator Programs

The CMS recently finalized a rule that would allow health insurers to implement copay accumulator programs to prevent drug manufacturer coupons from applying to a patient’s annual limit on out-of-pocket costs in situations where a generic drug is available. The copay “accumulator” program tracks employee use of a copay coupon and ensures the money does […]

Tabula Rasa HealthCare Acquiring PrescribeWellness

Tabula Rasa HealthCare (TRHC) is a leader in providing patient-specific, data-driven technology and solutions that enable healthcare organizations to optimize medication regimens to improve patient outcomes, reduce hospitalizations, lower healthcare costs and manage risk. TRHC provides solutions for a range of payers, providers and other healthcare organizations.  TRHC announced that it will be acquiring PrescribeWellness. […]

Telehealth Use by Skilled Nursing Growth Continues

The use of telehealth, or telemedicine, continues to grow across the skilled nursing market

Value-Based Contracting in Commercial Insurance

Background on risk-sharing and insight into risk-sharing agreements from a payer’s and manufacturer’s perspective.

Outcome-Based Contracting Acceptance Grows in Market

Specialty Pharma Services

Outcome-Based Contracting Acceptance Grows in market with the concept of taking on financial risk on complex contracts as a result of market pressure combined with more familiarity. Outcome-based contracts between pharma companies and health insurers are becoming increasingly popular. In 2016, Novartis, Amgen, and Sanofi publicized risk-sharing, value-based, outcomes-based, or pay-for-performance deals, all of which vary […]

Oncology Care Marketing Increasing

Knowsource.com Announces Transition to Access Market Intelligence

Oncology care marketing increasing in the U.S. marketplace. However, continuing benefit coverage planning for 2017 are also topics that are receiving increasing attention—to include cancer care. Just as the new oncology product pipeline is providing new options or treatments for a wide variety of cancers, market stakeholders are continuing to adjust their daily practices around providing […]

Specialty Drug Wave Hitting Medical and Pharmacy Plans Harder: Trends versus reliable benefit strategy to handle the impact through 2020?

Specialty Drug Wave Hitting Medical and Pharmacy Plans Harder: Trends versus reliable benefit strategy to handle the impact through 2020?The U.S. now has two different markets resulting from implementation of the Affordable Care Act (ACA) and resultant trends. Related to specialty or biological drugs, public sector CMS’s forecast of drug spending is somewhat counterintuitive, given […]