Dec 7, 2020 | Drugs, Medicare, Part D, Payers, Physicians
HHS proceeded with two rules aimed at reducing drug prices: benchmarking Medicare Part B prices to international levels and modifying the Part D rebate exemption from the anti-kickback rule. The rules now face legal challenges and the possibility of being reversed by the Biden Administration. Click to read more.
Dec 4, 2020 | Managed Care Friday
Social Service Payment: Identifying the social factors of health is part of a new program from a Michigan health plan. Starting in January, the plan will provide financial incentives to healthcare providers if they screen patients and report back these social risk factors. Click here to read more. Extra Point: At about 11:45am on Tuesday the 8th, one of our panel discussions will feature Mona Chitre, the longtime chief of pharmacy and VP of integrated clinical strategy for Excellus BCBS, the head of healthcare strategy and payment transformation from Blue Carolina, Troy Smith, and a pair of...
Nov 30, 2020 | 340B, BRG Publications
Our BRG colleagues Aaron Vandervelde, Kevin Erb, and Lauren Hurley have published a study on for-profit pharmacy participation in the 340B program. Their work examines the history and the growth of contract pharmacy within 340B and its impact on the program. Click to read more.
Nov 24, 2020 | ESRD, Medicare Advantage, Physician Fee Schedule, Physicians
Recent developments in nephrology reimbursement and legislation include E&M reform, value-based care initiatives, and full eligibility for ESRD enrollees to join Medicare Advantage plans. Click to read more.
Nov 20, 2020 | Managed Care Friday
$100M: The amount Ochsner Health in Louisiana committed to spending over the next five years to build community health centers in underserved areas. Louisiana consistently rates in the very bottom of US health rankings and the health system aims to increase their ranking by opening 15 centers across the state. They will be located strategically in rural and underserved areas, providing more alternatives to patients who frequently use the ER as primary care. Interception: An adult and pediatric practice in Nevada says Anthem’s teledentistry partner has “picked off some of the patients we...
