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Scaling back the Comprehensive Care for Joint Replacement model and canceling an expansion proposed under the Obama administration represents a shift in philosophy from mandatory to voluntary bundled payment models. But some say that commercial payers and employers will demand change no matter what CMS does.
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"Voluntary" is the key word in today's wellness programs, after EEOC rules were tested in court.

After great effort to resolve apparent conflicts between the ACA and older statutes, including the Americans with Disabilities Act, a repeal of the healthcare law may send regulators back to the drawing board.

At the Payer Exchange Summit V, sponsored by the Community Oncology Alliance (COA), 2 employer groups and a provider participated on a panel to provide practical insight into the extraordinary challenges and decisions faced by employers and employees with a cancer diagnosis.

Also, the share of employers funding wellness programs has passed the 50% mark, but not all employees use them.

More employers are requiring prior authorization and the use of select specialty pharmacies for high-cost drugs.

The Pregnancy Discrimination Act of 1978 prevents questions about status from being asked, and does not require a woman to disclose her pregnancy in an interview.

Incentives in employee wellness programs, especially penalties, can hurt morale and lead to legal action. But without incentives, there's no guarantee the employer will see healthcare savings and return on investment.


Employers and employees are seeing eye-to-eye when it comes to integrated health benefits. Not only do employees see how an integrated plan can improve quality of care and health, but employers see how it makes good business sense.

The accountable care organization, or ACO, can be a mechanism for employers to achieve healthcare savings, according to a just-published article in The American Journal of Accountable Care, the publication of The American Journal of Managed Care dedicated to healthcare reform.

Retail health insurance marketplaces, also known as exchanges, are on the cusp of dramatically changing the health insurance business, according to a new report from PwC's Health Research Institute.

Can a diabetic's likelihood of developing complications depend on picking the right doctor? A study suggests it can.

MedImpact, a leading pharmacy benefit manager, will contribute the "Drug Trends" column for AJPB.

The American Journal of Pharmacy Benefits (AJPB) and the Pharmacy Benefit Management Institute (PBMI) today unveiled a strategic partnership between the two organizations, which will provide professionals in the pharmacy benefit management industry with free access to both AJPB and its flagship publication, The American Journal of Managed Care (AJMC).














