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Read what a panel of distinguished industry experts has to say about the increasingly difficult job of managing specialty pharmaceuticals.
Blue Cross Blue Shield of Massachusetts has taken big steps to curb the growing opioid addiction problem.
Many employers that offer generous health insurance packages are not looking forward to 2018, when the so-called Cadillac tax will impose a 40% penalty on high-cost health plans.
Spurred on by the Affordable Care Act, retailers, health plans and providers are staking strong retail positions that are increasing coverage opportunities and access to care.
Public and private insurers are seizing the opportunity to devise programs that promote preventive care and positive behaviors.
From Blue Shield of California's recently-announced purchase of a Medicaid plan to Partners HealthCare's hard-fought effort to fold more hospitals into its Massachusetts health system, the volume of mergers and acquisitions...
Envisioning a public health threat, managed care recently notched up its readiness for an Ebola outbreak in the United States. Valuable lessons emerged from the latest effort, adding to the knowledge gleaned from other epidemics, such...
Unlike a traditional formulary, the value-based formulary emphasizes the clinical effectiveness of a drug rather than cost so that if a drug is very effective but expensive, it might still fall on tier one.
Nearly a year after two medical societies released a national consensus statement on the safe prevention of certain C-sections, broad consensus seems to boil down to this: Steps must be taken to lower C-section rates in the U.S., and...
The industry is challenged by a number of issues in 2015 including cost control, technology threats, and the emerging consumer market.

INDUSTRY ANALYSIS
Half would owe IRS for ACA subsidies ...

Half of all consumers who received advance tax credit subsidies for health insurance in 2014 would have to pay back a ...

Protections offered as breach of 11 ...
Non-PCP blood pressure screens lead ...
ACA provisions will cost $142 ...

PHARMACY BEST PRACTICES

ACCOUNTABLE CARE
HHS launches Next Generation ACO model

A new, “next generation” accountable care organization model that encourages greater coordination between providers and ...

6 developments bring optimism back ...
UnitedHealthcare enrolls 11 million ...
Analytics a top priority for ...

POLICY
ACA’s medical loss ratio provision works

The Affordable Care Act’s medical loss ratio provision yielded more than $5 billion in benefits to consumers from 2011 ...

ONC finalizes roadmap for ...
Bill would require drug companies to ...
11 million sign up during ACA's ...

LEGAL
The risks and rewards of medical ...

Executives of Medicare managed plans can benefit from knowing the challenges of the Medical Loss Ratio, a key cost ...

Bad Apple rule updated by CMS
ICD-10's impact on reimbursement
Federal subsidies questioned

FOR YOUR BENEFIT
The Internet of (Health) Things

The digital revolution of the Internet of Things (IoT) has advanced the fields of home automation, automotive, energy and ...

MA market's downside could be a ...
Reforming reimbursement
Three game changers threaten the ...

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