Jul 30, 2021 | Managed Care Friday
$140M: The amount Anthem and Humana are investing in a new pharmacy benefit manager. With this investment, the plans will hold a minority stake in the new company, DomaniRx. SS&C Technologies, a fintech company, will own the other 80%. Humana will be the PBM’s first customer, as the company “aims to offer payers more transparency into their drug costs and help them better comply with changing government regulations” according to a press release. Did You Hear About The Detox Fix? A noninvasive treatment to manage opioid withdrawal symptoms recently hit the market. S.T. Genesis looks like...
Jul 23, 2021 | Managed Care Friday
517,000: Cost of medical and pharmacy claims for a small cohort of caregivers one health plan utilization analyst studied this year. The patients “take care of sick relatives, then they get sick from the stress.” The analyst said she’s providing a report to the medical and product design teams in the fall with “stats and case examples” like the 57-year-old who had zero claims cost for the prior 5 years outside of check-ups then a 3-year uptick that led to a heart attack” One idea she’s going to float is a division of labor system that “weans” hours, gradually taking the caregiver “from the...
Jul 16, 2021 | Managed Care Friday
25: The number of retail pharmacies health system Intermountain is closing, citing declining business and a new deal with CVS Health. Intermountain will keep its pharmacy at Primary Children’s Hospital in Salt Lake City open as a home delivery, retail, and specialty pharmacy. All others will transfer inventory and patient files over to CVS by August. Spartan Care: Michigan State University Health Care is partnering with Everside Health, a direct primary care provider, to provide employer-sponsored health plans with access to direct and virtual primary care across the state. Employers who...
Jul 9, 2021 | Managed Care Friday
42: Percent of kids going off to college in August, according to a poll of my son’s 1,700 Instagram followers—up from 30% recently—who say they are bringing the following to college: a 10-pack of blue iPhone chargers, an old “beat up locker passed down from generations,” and the phone number and text for a mental health therapist. Here’s to something borrowed, something blue, and something new. Insulin? Aisle 12: Walmart is launching its own brand of insulin, a less expensive version of Novo Nordisk’s analog insulin product, Novolog. The insulin will be under Walmart’s private label and will...
Jul 2, 2021 | Managed Care Friday
5: The number of BCBS plans that have created a new pharmacy solutions company, Evio. The Blues plans in Massachusetts, Michigan, and California, along with Highmark and Independence are behind the company, which will use member data to track how drugs perform. One main goal is to enter into outcomes-based arrangements with drug manufacturers, so the plans are only paying when drugs are effective for members. Biosimilar Bait & Switch: Cigna is also looking into innovative ways to save on drug costs, by focusing on biosimilars. The health plan is launching the new Shared Savings Program...
Jun 25, 2021 | Managed Care Friday
31: Percent of 17 to 20 year-olds in my son’s poll of his 1,379 so called Instagram followers who say they found a mental health therapist recently before they head off to college. “It’s a good idea to get that relationship formed before going into college,” says Ivy Patt, a therapist in Connecticut who deals mostly with private pay teens. Most of these relationships will be virtual and from a managed care point of view that’s perfect, as long as it is privately paid and if through insurance, the encounters make sense to “help with the transition” as long as they are necessary. Therein lies...
