NEW YORK (Reuters)—Walmart and Home Depot, two of the top 10 U.S. employers, have embraced a health insurance strategy that punishes drugmakers for using discount cards to keep patients from switching or stopping their medications. Large U.S. companies have started tightly managing how employees and their family members use these popular discount, or copay, cards…
Search results for: pharmacy benefit managers
ACR/ARHP Heads to D.C. for Advocacy Leadership Conference
ACR/ARHP leaders are once again heading to Washington, D.C., to advocate for legislation important to rheumatologists and their patients. On May 16–18, more than 100 representatives of the ACR Board of Directors, Executive Committee, Government Affairs Committee, RheumPAC, Committee on Rheumatologic Care, Insurance Subcommittee and Affiliate Society Council and others will talk to members of…
5 Steps to Help You Manage Prior Authorizations
Despite continuous movement to streamline the prior authorization process, physician practices are still struggling with jumping through hoops to have procedures and medications covered. A prior authorization (PA) is the process insurance carriers have in place to approve or reject prescriptions based on plan formulary. The PA process is important in ensuring appropriate and cost-effective…
Amazon, Berkshire, JPMorgan Partner to Cut U.S. Healthcare Costs
NEW YORK (Reuters)—Amazon.com Inc., Berkshire Hathaway Inc. and JPMorgan Chase & Co. said on Tuesday they will form a company to cut health costs for hundreds of thousands of their employees, setting up a major challenge to an inefficient U.S. healthcare system. The move by three of the best-known U.S. business leaders—Amazon’s Jeff Bezos, Berkshire’s…
CVS Health to Acquire Aetna for $69 billion
(Reuters)—U.S. drugstore chain operator CVS Health Corp said on Sunday it had agreed to acquire U.S. health insurer Aetna Inc. for $69 billion, seeking to tackle soaring healthcare spending through lower-cost medical services in pharmacies. This year’s largest corporate acquisition will combine one of the nation’s largest pharmacy benefits managers (PBMs) and pharmacy operators with…
Valeant Hires Attorney, Crisis Management Firm as U.S. Scrutiny Mounts
WASHINGTON/NEW YORK (Reuters)—Pharmaceuticals firm Valeant, under mounting pressure from Congress and prosecutors over its drug pricing, has hired an attorney in Washington, D.C., and crisis public relations experts with political connections, according to sources familiar with the matter. The move, confirmed by sources and through documents viewed by Reuters, signals a shift for Valeant Pharmaceuticals,…
What Has the ACR Done for You Lately?
The world in which we currently practice is not the same one we knew five to 10 years ago. Insurers second-guess our decisions and create numerous hurdles for us to overcome before our patients can be treated. Government agencies are seeking ways to reduce healthcare expenditures and improve what they perceive as a lack of quality and consistency in healthcare delivery. These groups, as well as Congress and employers (who purchase benefits for their employees), have begun a concerted effort to grade rheumatologists on the basis of what they perceive to be quality and efficiency and then pay us according to those criteria.
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