Payers

Contributor: Value-Based Care Will Provide the Freedom to Fix What's Broken in Rural Health

May 22nd 2022, 12:30pm

Article

The tools we need to achieve long-term stability for community providers and ensure better outcomes for rural Americans are available, and CMS can help us utilize them.

Oncology Drugs Dominate Medical Benefit Spend

May 18th 2022, 1:20pm

Article

Across commercial insurance, Medicare, and Medicaid populations, oncology is the top category of spend, and the drug pipeline has increasing specific and complex therapies.

Trends Show Uptake of SUD Treatment Has Room for Improvement

May 17th 2022, 6:00pm

Podcast

On this episode of Managed Care Cast, we speak with one of the authors of a paper published this month in Health Affairs about the utilization of substance use disorder treatment (SUD) services between 2010 and 2019, and why more needs to be done to get more individuals into treatment.

RAND Report Assesses Hospital Prices Paid by Employers, Private Insurers

May 17th 2022, 4:00pm

Article

The report details totals paid to hospitals by private insurers and providers and compares the sums with a Medicare benchmark.

Dr Sonia Oskouei on Managed Care’s Impact After Rollout of Adalimumab Biosimilars

May 16th 2022, 1:05pm

Video

While 2023 is a big year with at least 7 adalimumab biosimilars expected to come to market, 2024 will be even more important because all the products will be on the market and formulary decisions can be made, said Sonia T. Oskouei, PharmD, BCMAS, DPLA, vice president of biosimilars at Cardinal Health.

Walgreens’ Ray Tancredi Weighs in on Expensive Hemophilia Gene Therapies in the Pipeline

May 13th 2022, 5:59pm

Video

Gene therapies in the pipeline to treat hemophilia will be very expensive, but they also seem to be very efficacious, and multiple could hit the market between now and 2024, said Ray Tancredi, RPh, MBA, CSP, divisional vice president, specialty pharmacy development and brand Rx/vaccine purchasing, Walgreens.

Jayson Slotnik Discusses Using Payment Models to Address Health Equity

May 13th 2022, 2:35pm

Video

While CMS has started making changes to address health equity through policy and payment models, commercial plans are waiting to see the outcomes before they follow suit, said Jayson Slotnik, partner, Health Policy Strategies, Inc.

A Look at the Current, Future State of Cell and Gene Therapies in the United States

May 12th 2022, 4:38pm

Article

Experts evaluated the future of cell and gene therapies in the United States and offered insights on potential value-based payment models for these treatments.

Managed Care Has a Key Role in Biosimilar Adoption, Says Cardinal's Oskouei

May 12th 2022, 1:17pm

Article

Biosimilar adoption can be accelerated or stymied depending on actions taken by the managed care space, explained Sonia Oskouei, PharmD, vice president, biosimilars, Cardinal Health, during a session at Asembia’s Specialty Pharmacy Summit.

What's Behind Lagging Payer Uptake of Prescription Digital Therapeutics?

May 10th 2022, 2:09pm

Article

In a session at the 2022 Asembia Specialty Pharmacy Summit, Jayne Hornung, chief clinical officer at Managed Markets Insights & Technology (MMIT), outlined factors driving payer hesitation when it comes to covering prescription digital therapeutics.