A recent analysis prepared on behalf of America’s Health Insurance Plans (AHIP) indicates that drug rebates have not been the primary driver of rising drug prices—as some advocates have claimed.
Category: FierceHealthPayer
Medicare Advantage plans taking advantage of new policies that give them flexibility
“High-touch” services can improve satisfaction among patients with serious or advanced illnesses while reducing costs, a new paper from Duke-Margolis says.
New Mexico Health Connections to appeal portions of risk adjustment ruling regardless of pending decision
As a New Mexico district judge weighs a request from CMS to reconsider the court’s risk adjustment ruling, the lead attorney for New Mexico Health Connections said the insurer plans to appeal portions of the court’s February ruling.
CMS revives Kentucky waiver debate, puzzling legal experts
CMS plans to open a second 30-day comment period on Kentucky’s Medicaid work requirement waiver, a move that has experts scratching their heads, especially as numbers from Arkansas’ work requirement demonstration roll in.
CMS readies potential fix to risk adjustment payments
The Office of Management and Budget is reviewing an interim final rule from CMS on the “ratification and reissuance of the methodology” for the risk adjustment program, a sign the agency may be preparing to unfreeze the payments.
In a blow to PBMs, Trump administration mulling overhaul to drug rebate safe harbor protections
The Trump administration is considering a proposal to overhaul safe harbor protections for pharmaceutical company rebates, a plan that could lead to a significant shift in how drug prices are determined.
Altarum: Growth in spending on privately insured patients outpacing Medicaid, Medicare
A new analysis from the Altarum Institute found that spending and price growth among the privately insured sped up in 2017 and the first half of 2018 compared to public payers. It’s a reversal from prior trends when private spending growth was near or …
GAO finds 340B hospitals are mostly rural or qualify for DSH payments
Amid increased scrutiny of the 340B drug discount program, the Government Accountability Office has released a report diving into the characteristics of hospitals in the program.
Doctors, executives see little progress on value-based care
Value-based healthcare may be the hot topic right now, but all that attention has yet to make much of a mark on the industry. That’s the perspective of physicians and health plan executives who said that despite advances in technology, there’s still a …
Maryland health regulator expands hospital price transparency efforts
The Maryland Health Care Commission expanded its price transparency initiative with hospital cost comparison tools to inform consumers about large differences in price and quality—and push hospitals to examine their costs.
