Managed Care News

The existing approach to disease management may be ill-suited to address the dynamic and diverse factors at play when it comes to chronic illness.

A perspective on the CMS Innovation Center roundtable on health equity.

Let’s raise a glass to all the pharmacy owners who are improving patient health outcomes by providing innovative services.

Women and those in their 50s and early 60s reported the most stress about COVID-19

Continued vigilance is needed in the health care field to only prescribe antibiotics when they are truly needed.

In honor of American Pharmacists Month, here are 4 pharmacists making a significant difference in the communities they serve.

Burnout has peaked in community pharmacies across the country. Dana Sadowski, PharmD, is combatting burnout by helping independents reach more patients and provide higher quality care.

Addressing the needs of LGBTQ+ patients requires insight, innovation, and introspection.

The Department of Health and Human Services recently released a final rule requiring health insurers to disclose drug pricing and cost-sharing information

New policy recommendations aim to increase the uptake of biomarker testing and advance health insurance coverage for precision medicine in cancer care.

A plus for both patients and pharmacists

A group of pharmacies and pharmacy organizations urged the Centers for Medicare & Medicaid Services to formally recognize and promote medical at home pharmacy services for long-term care.

A new poll by Gallup and West Health found that a majority of Americans have expressed numerous health care system-related concerns, including rising costs of drugs, insurance premiums, and health care in response to COVID-19.

New changes are making it more difficult for generics and biosimilars to compete on formularies.

New study shows that a Universal Medication Schedule could help diabetes patients.

Pharmacists on P&T committees are going to face issues that range from biosimilar naming systems to challenges in dispensing and costs.

“Basically, everything we know will be gutted over the next three years.”

According to PBMs, those drug coupons are something else.

PBMs have dodged state-mandated requirements for transparency in generics drug pricing, so many states are rewriting their laws.

Five years of imatinib treatment for CML = >$100,000 saved per patient.

Value-based care is transforming the world of healthcare. Simple cost management must give way to utilization management, and alignment of stakeholder services is inevitable.

Cost of treatment often forces aging patients on limited incomes to choose between paying for medications or for food and rent.

Key trends point to a collaboration between pharmacies and healthcare stakeholders that will shape better delivery of patient education, adherence support, and financial assistance.

Validation through inclusion in Medicare Part B could lead to recognition of pharmacists as healthcare providers across the board.

A group of 55 pharmacies located mainly in Pennsylvania has turned to the courts to resolve reimbursement differences with Catamaran.

Discounts and rebates negotiated by some third-party payers are ensuring the place of hepatitis C drugs in their formularies.

As specialty pharmaceuticals consume more of the healthcare dollar, the role of managed care pharmacy will be critical.

An 18-month statewide program to decrease painkiller prescriptions and lower addiction risks resulted in 6.6 million fewer doses dispensed, Blue Cross Blue Shield of Massachusetts recently announced.

Express Scripts and CVS Caremark are expected to expand their list of non-covered drugs for the 2015 plan year, leading to challenging pricing negotiations between branded pharmaceutical companies and PBMs.

Some people credit ACOs with lowering healthcare costs and improving quality. But a new study reveals that while ACOs are performing well in some areas, they fall woefully short in many others.