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RADAR on Medicare Advantage
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Through partnerships with two technology-enabled supplemental benefits companies, Walmart Inc. aims to provide Medicare Advantage members and other shoppers with easier access to covered benefits and items that align with their wellness goals. Through its new Walmart Everyday Health Signals program...
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From its Medicare Part D partnership with Humana Inc. to the recent launch of the Everyday Health Signals program, Walmart Inc. has a long history of supporting health care consumers, including Medicare Advantage and managed Medicaid members. AIS Health, a division of MMIT, culled its archives...
HEALTH PLAN WEEKLY
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The budget reconciliation bill that President Donald Trump signed into law on July 4 will have a major impact on state directed payments (SDPs) that insurers are sometimes required to make to providers serving managed Medicaid beneficiaries. One health policy says the cuts may contribute to slower adoption of value-based care among managed Medicaid insurers.
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Donald Trump's administration has kept most of the Biden-era health care antitrust rules in place, according to speakers at a July 9 Manatt webinar. Still, they suggested that this administration may be slightly more open to the idea of divestitures as a remedy for antitrust concerns than the previous administration.
Radar On Speciality Pharmacy
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While it appears unclear whether the administration is intending for most-favored nation (MFN) pricing to apply to commercial health plans, most stakeholders agree that it would be extremely difficult to do. But if the administration is successful in putting MFN into effect in at least Medicare, private insurers could feel the impact.
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The advanced therapies market shows no signs of slowing, as scientific innovation continues to bring revolutionary new treatments out of the laboratory and onto the U.S. market. But some barriers to access, including the lack of patient caregiver support, payer hurdles and high costs, still remain and must be overcome if these agents are able to realize their potential and be even more impactful than they already are, according to a recent report from Cardinal Health.
RADAR ON DRUG BENEFITS
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Although high-cost prescription drugs are increasingly busting U.S. employers’ budgets, companies face significant barriers when trying to upend the pharmacy benefits management status quo, panelists said during a recent conference in Washington, D.C.
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Billionaire investor Mark Cuban, speaking at a Washington, D.C., conference on June 24, said the Mark Cuban Cost Plus Drug Co. can’t fully disrupt the pharmacy benefits space because the country’s three biggest PBMs have too much leverage over drug manufacturers.
About AIS Health
AIS Health is a publishing and information company that has served the health care industry for more than 30 years. Our mission is to provide our readers with an actionable understanding of the business of health care and pharmaceuticals. Our in-depth writing covers the companies, people, catalysts and trends that create the richly textured contours of the health care and drug industry. AIS Health maintains journalistic independence from our parent company, MMIT. We are committed to integrity in reporting and bringing transparency to health industry data.
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