Session highlights from the Managed Markets Summit in Orlando, FL, February 25-27.
Health Insurance Exchanges: Challenges and Opportunities for Pharma
Dennis M. Falci, MBA, director, Sanofi-Aventis SA, says it’s no secret—Health Insurance Exchanges (HIEs) are a hot topic in health news.
HIEs are mandated as part of the Affordable Care Act (ACA), providing coverage to nearly 44 million people in the United States. Likening the exchanges to consumer tools such as Expedia, Mr Falci says insurance marketplaces function as a “one stop shop for healthcare,” helping Americans to find health plans that “meet their needs and reflect their eligibility.”
Once consumers are logged on a HIE web portal, they can choose from a variety of health plans. Levels of coverage include:
The Current State of Our Nation's Public Exchange Programs and the Rise of Private Exchanges
In a panel discussion moderated by Neil Minkoff, MD, CEO of FountainHead HealthCare, panelists examined the current state of healthcare exchanges, both public and private. Panelists included Dennis Falci, MBA, director, US managed markets training, sales training and leadership development, Sanofi-Aventis SA; Thomas Kaye, director of consulting pharmacy, Prescription Formulary Exchange, LLC; and Sheri Sellmeyer, vice president, market analysis, HealthLeaders-InterStudy, a Decision Resources Group Company. They analyzed the current benefit models required by public exchanges, and the rising popularity of the private counterparts, offering a glimpse into the new healthcare marketplace now unfolding.
One of the major topics of discussion was resistance to mandatory health coverage, particularly among younger Americans. Falci, drawing on his own experiences, surmised that many of those who are young and in good health do not want to "overinsure" themselves with insurance plans that cover services generally utilized by older participants, especially when those plans come with high deductibles. Similarly, high co-pays and costly treatments could sway people to voluntarily decline pharmaceuticals and could promote non-compliance. Read more here: http://bit.ly/1o8L5N5
Continuing conference coverage and exclusive interviews from The Managed Markets Summit are available here: http://www.ajmc.com/conferences/mms2014
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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Oncology Onward: A Conversation With Penn Medicine's Dr Justin Bekelman
December 19th 2023Justin Bekelman, MD, director of the Penn Center for Cancer Care Innovation, sat with our hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, for our final episode of 2023 to discuss the importance of collaboration between academic medicine and community oncology and testing innovative cancer care delivery in these settings.
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Posters Detail Effects—and Uncertainty—of Drug Pricing Negotiations
May 7th 2024Research into the Inflation Reduction Act evaluated payer concerns, patient and physician behavior, which patients will benefit from the first 10 drugs selected for price negotiation, and the ripple effect into Medicaid at the state level.
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