payers
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Pharma, BioPharma, Legal, Payers
HHS Cites 27 Medicare-Covered Drugs Whose Prices Rose Faster Than Inflation
Companies who raised drug prices higher than the rate of inflation must rebate the difference to Medicare, according to a provision of the Inflation Reduction Act. The highest-profile product on the list might be AbbVie’s blockbuster immunology drug Humira.
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Interoperability and Price Transparency in the 21st Century Cures Act: A Payer’s Perspective
A webinar sponsored by Intelligent Medical Objects April 11 will explore how payers are meeting the needs of the 2016 21st Century Cures Act when it comes to providing unfettered access to structured medical data for members.
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Payer’s Place: Dr. Anil Singh
Dr. Anil Singh shares his insights into the strategies employed by the organization to identify the most effective digital solutions for their members.
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Price Transparency Compliance Is a Very Different Story for Hospitals Vs. Payers
Payers and providers face different challenges when it comes to compliance. The volume of price transparency data that hospitals must disclose online amounts to about 3 terabytes — compared to the whopping 630 terabytes of data that payers have been tasked with posting.
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Consumers Need Better Communication From Their Health Plans, Survey Shows
More than half, or 58%, of health plan members are “overwhelmed” when it comes to managing their health plans. Insurers need to provide information in a way that’s accessible and easy to understand, the report stated.
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How payers, employers can expedite healthcare’s transition to value-based care
Moving to value-based care models isn’t easy. But payers may be in the best position to make this change, according to the Business Group on Health. Employers, meanwhile, can encourage their employees to receive care from providers participating in value-based care.
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HealthEdge survey: Costs are top-of-mind for health plan leaders
When asked what their biggest difficulties are today, 46% of payer leaders said managing costs and 41% said driving operational efficiencies. The reason for this could be increasing claims volumes from the Covid-19 pandemic, rising costs from people delaying care and the use of outdated systems, the survey said.
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Tomorrow Health raises $60M to get more payers on its home care coordination platform
Tomorrow Health — a platform that makes it easier for patients, providers and payers to coordinate home-based care — closed a $60 million Series B funding round on Tuesday, bringing its total funding to date to $92.5 million. The startup will use the funds to expand its partnerships with payers, grow in new markets and further develop its technology.
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Health tech vendors can be the middleman that improves payer-provider relationships
Even though payers and providers still struggle to effectively collaborate, health tech vendors can often act as a linking agent to improve outcomes for both sides.
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Hospitals, Consumer / Employer, Health Tech, Payers
Turquoise Health raises $20M to boost price transparency
Pulling back the curtain on healthcare pricing is easier said than done, acknowledged Chris Severn, the company’s co-founder and CEO. That’s exactly why the investment is so important.
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Discover the Next-Gen Platform for Integrated Collaborative Care
Beyond EHRs and digital front doors, reducing the gaps in patient care journeys.
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MedCity Influencers, Health Tech, Payers
Payers can lead the way in modernizing commercial dental benefit administration
Dental payers can no longer rely on the processes, methodologies and technologies of the past. They must adopt new technologies, like automation, that deliver the level of performance required to compete in today’s digital world.
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StartUPDATES: New developments from healthcare startups
Check out new developments from Seven Bridges, Healthmine, Bright Health, and My One Medical Source.
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How payers are playing a part in new value-based outcomes strategies
Value-based healthcare puts the focus on patient outcomes, but payers have a part to play as well. A panel at MedCity News’ INVEST conference discussed how reimbursement strategies can improve patient care and reduce costs.
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CMS proposes limited coverage of Biogen Alzheimer’s drug, only in clinical trials
The Center for Medicare and Medicaid Services proposes covering Biogen Alzheimer’s disease drug Aduhelm only for people enrolled in a clinical trial. In explaining this proposal, the agency cited the unclear benefit to patients as well as the documented safety risks associated with the drug, which can be best monitored within the context of a clinical trial.
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Biogen slashes price of Alzheimer’s drug by half as CMS coverage decision looms
The price of Biogen Alzheimer’s disease drug Aduhelm will be cut in half at the start of 2022, a move that comes as a Medicare recommendation on coverage is expected early next year. Meanwhile, Biogen is preparing corporate measures projected to save $500 million annually, cost-cutting made necessary in part due to slow market uptake of Aduhelm.
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Survey: These are the risk-based payment models health systems are pursuing
According to a recent survey, 59% of hospital finance leaders are looking to advance into Medicare Advantage models next year. They still face obstacles in switching to risk-based models, including striking partnerships with payers and having the needed technical capabilities.