How Capitation Contracts Benefit Providers, Payers and Patients
May 11, 2023 · Capitation contracts can benefit providers, payers, and patients. But they require thoughtful planning, careful alignment between PCPs and specialists, a commitment to optimizing the patient/member experience within a narrower network of providers, and a robust digital infrastructure. Lynn Carroll is the chief operating officer of HSBlox, an ...
Lilly Introduces Zepbound Single-Dose Vial for Cash-Paying Patients
Aug 27, 2024 · Article. The monthly price of the 2.5 mg Zepbound single-dose vial is $399 and the 5 mg dose is $549, which Lilly officials said is in line with the savings program for without insurance. Lilly has released a single-dose vial version of Zepbound (tirzepatide) for self-pay patients. The single-dose is available in 2.5 mg and 5 mg doses.
Beyond the Big Three PBMs - Managed Healthcare Executive
Dec 19, 2022 · But beyond the big three PBMs is a swarm of some 60 smaller, up-and-coming PBMs. Even if they are operating in a small slice of the pie relative to the towering dominance of the big three, the PBM pie is growing rapidly. The global PBM market is projected to increase from $495 billion in 2022 to $740 billion by 2029 (a 50% jump), according to a ...
Five things to know about the role of GPOs in the healthcare …
Sep 14, 2017 · Based on our analysis, the following are 5 things to know about GPOs, their business model and role in the supply chain, and their impact on healthcare costs and competition: 1. GPOs source and negotiate prices for products and services. GPOs help source and negotiate prices for drugs, medical devices, and other products and services on behalf ...
Express Scripts to Remove Humira from Commercial Formularies
Aug 26, 2024 · Beginning in 2025, Express Scripts will remove Humira (adalimumab) from its commercial formularies, favoring instead several biosimilars. Biosimilars that will be available include. Cyltezo (adalimumab-adbm) and its unbranded version (Boehringer Ingelheim) in both high- and low-concentration formulations. Simlandi (adalimumab-ryvk) (Teva), the ...
PBMs are Creating GPOs, and Stirring Debate as to Why
Jul 12, 2022 · PBMs are Creating GPOs, and Stirring Debate as to Why. The Big Three all set up group purchasing organizations recently, but some industry observers question the timing of the move and who will benefit. In 2019, Express Scripts PBM (pharmacy benefit manager) formed Ascent Health Services GPO (group purchasing organization), based in Switzerland.
Conferences - Managed Healthcare Executive
Managed Healthcare Executive provides C-suite executives at health plans and provider organizations with news, analysis, insights, and strategies to pursue value-driven solutions.
FHIR Interoperability: What is it and Why Should We Care?
Jun 11, 2020 · Article. Fast Healthcare Interoperability Resources, or FHIR, is a long-awaited interoperability rule that will enable seamless, on-demand information exchange of clinical records among providers and data systems and will result in coordinated, cost-efficient care. Early in March 2020, the Office of National Coordinator of Health IT (ONC) and ...
CVS CEO Karen Lynch Takes over Day-to-Day Management of Aetna
Aug 7, 2024 · Aetna president Brian Kane has left CVS Healthcare, and CEO Karen Lynch will assume direct leadership of the company’s Health Care Benefits segment. The move was made to address the continued pressure in the company’s healthcare benefits business, Lynch said during an investor call this morning. Kane had joined the company in September 2023.
The Biggest Issues Facing Healthcare Today - Managed Healthcare …
Sep 26, 2019 · The Biggest Issues Facing Healthcare Today. Healthcare executives rank the top 10 transformational themes for 2020. More than 100 C-suite and director-level executives voted on and then ranked the top 10 critical challenges, issues, and opportunities they expect to face in the coming year, during the 2019 HCEG Annual Forum.