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Meeting the ‘status quo’ with CMS Star Ratings equals regressionCMS’ 5-Star Rating system requires proactive intervention to improve patient medication adherence, and leaves plans with little room to rest on their laurels.
Payers need access to pre-approval drug informationPre-drug-approval forecasting and budgeting is increasingly important for payers. Is a safe harbor for manufacturers necessary?
Survey: How payers use nonpayer generated data to make formulary decisionsExternal, non-payer generated data can inform formulary decision-making—if payers know their strengths and weaknesses.
Study: Formularies may be key to alleviating opioid epidemicNew Yale University research offers stunning findings about drug formulary coverage and prescribing opioids.
Five ways to increase physician engagementOne expert says incentive programs to motivate physicians miss the mark. Here’s what he recommends instead.
Program uses provider, patient incentives to fight opioid epidemicProviders are coming up short when it comes to HEDIS measures related to substance abuse. Here’s how one health plan is changing that.
Top strategy plans, providers can use to motivate member behavior changesAs the healthcare system shifts from a focus on employee-based plans to consumer-based plans, insurers have to find new ways to engage and motivate members.
Specialty drug pipeline predictions: Seven key areas to watchThe specialty drugs market will see more approvals in 2017 than 2016. Top areas to watch include cancer, multiple sclerosis, and HIV.
Highly specific indications dominate cancer drug pipelineRecent and pending drug approvals emphasize the growing importance of niche agents for very specific cancer patient populations.
Monetary benefits from value-based diabetes plans take timeValue-based insurance designs for diabetes care improve outcomes, but monetary gains may take years.