Combined with a number of recent acquisitions and ongoing consolidation by market participants, we view the primary care market undergoing a major transformation over the next few years.
Blue Cross Blue Shield Plans have been involved in a number of network contracts during the last quarter of 2022
OutcomeRx focuses on engaging with biotech companies to think through, structure, and manage value-based agreements
Manufacturers are increasingly being affected by the commercial insurance market’s shift of medical coverage policies to lower-cost alternate sites
Consumer use of drug discount programs has shown rapid growth
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 […]
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 […]
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 […]