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Optum Rx moves 8 insulins to ‘preferred’ status in bid to reduce costs
At the start of next year, pharmacy services company Optum Rx will place eight preferred insulin products on Tier One of standard commercial formularies, limiting out-of-pocket spend to $35 or less.
The UnitedHealth Group subsidiary said this action i…
Senate Finance Committee targets PBM reform in new legislation
In a unanimous 26-0 vote, the Senate Finance Committee passed a comprehensive draft package this week that puts pharmacy benefit manager reform and mental health in the spotlight.
Pharmacists treating hypertension could save health system $1.1 trillion
The U.S. healthcare system could stand to save more than $1.1 trillion over the next 30 years while preventing roughly 15 million heart attacks if pharmacists were more involved in treating hypertension, according to research from Virginia Commonwealth…
Medicare Advantage beneficiaries see better health outcomes
People with Medicare Advantage tend to have stronger health outcomes than those with fee-for-service Medicare, seeing fewer hospitalizations and readmissions, according to research published by Inovalon.
Using its unique data assets and analytics to lo…
New Hampshire leads in healthcare job listings per capita
Those seeking work in the healthcare industry would do well to look to New England: According to a new analysis from Tebra, New Hampshire has the most healthcare job listings per capita, followed by Maine and Massachusetts.
Rounding out the top 10, in …
Envision achieves financial restructuring, slashes 70% of debt
Nashville-based medical group Envision Healthcare, which filed for Chapter 11 bankruptcy in May, has completed and emerged from its restructuring process with a markedly strengthened capital structure and is ready to grow, the company announced.
CMS proposes rule to tighten Medicare Advantage marketing
In an effort to crack down on predatory Medicare Advantage marketing practices, the Centers for Medicare and Medicaid Services has issued a proposed rule it says will improve marketplace competition and limit plans’ payments to brokers.
Kaiser Permanente net income grows to $239 million in Q3
Kaiser Permanente is in a drastically different financial situation than it was a year ago, having posted $239 million in net income for the third quarter. That’s up from a net loss of $1.5 billion in Q3 2022.
Democrats press CMS on AI-based claims denials in Medicare Advantage
Democratic lawmakers in the U.S. House of Representatives have penned a letter to the Centers for Medicare and Medicaid Services, asking the federal agency to analyze artificial intelligence use in Medicare Advantage plans with an eye toward reducing c…
Hospital groups criticize HHS remedy for 340B payments
Hospital groups are unhappy with the U.S. Department of Health and Human Services after the agency released a final rule to fix the now-defunct 340B-acquired drug payment policy for 2018 to 2022.
