Market Access

Physician practice ownership set for radical change as COVID-19 strains finances

The COVID-19 pandemic is fundamentally changing healthcare delivery in the United States, from the acceptance of virtual physician visits to payment reform, and from the consolidation of integrated delivery networks to the very survival of independent physician practices. Clarivate market access expert Heather Johnson discusses how physician practice ownership is expected to evolve due to the pandemic. […]

Telehealth here to stay as unprecedented times drive innovation

The COVID-19 pandemic is fundamentally changing healthcare delivery in the United States. Clarivate market access expert Valerie Pillo discusses where the telehealth market is heading post-pandemic.   Telehealth has played a critical role in healthcare delivery during the COVID-19 pandemic, advancing its capabilities years ahead of its expected trajectory. It will likely become an integral part of […]

Trump targets drug prices – 5 implications for pharma

On July 24, 2020, President Trump signed several executive orders directing the secretary of Health and Human Services (HHS) to take steps to lower drug prices. The directive includes the following measures: 1. International pricing index The most aggressive policy directive tasks the HHS secretary with linking the price of Medicare prescription drugs to an […]

Retail Giants Reshaping Primary-Care Focus

Walgreens $1 billion in-store physician model may improve patient outcomes A series of partnerships and developments sweeping through the convenient care sector this past year is causing major drugstore retailers CVS-Aetna, Walgreens and Walmart – along with payers Blue Cross Blue Shield and Humana – to battle for control over patients’ healthcare decisions. These patients […]

Which Exchanges Will UnitedHealth Enter in 2021?

On May 12, 2020, UnitedHealthcare announced that it filed to offer individual health plans in Maryland for 2021, and more announcements should be forthcoming UnitedHealth Group generated a buzz in its 2020 first quarter earnings call by revealing intentions to reenter health insurance exchanges in 2021. The insurer has a short history of offering plans […]

The European MDR: Impetus, Impacts, And Current Status

In May 2017, the European Medical Devices Regulation (MDR), approved by the European Council and European Parliament earlier that year, came into force, setting the stage for its application. Initially set as May 26, 2020, the MDR DoA was postponed one year in April 2020 in response to the COVID-19 pandemic. The regulation was introduced […]

COVID-19 Complicates Value-Based Care

Value-based care contracts are adding a layer of complexity for provider organizations impacted by COVID-19. As part of these contracts, provider organizations often assume financial risk for commercial, Medicaid, or Medicare patients, in addition to responsibility for meeting quality benchmarks. Potential impacts of the pandemic on provider organizations engaged in value-based care arrangements include: Cost […]

COVID-19 Brings Seismic Shifts to Future Healthcare Delivery

The coronavirus pandemic is rapidly reshaping the way patients access care and the strategy of healthcare providers treating those patients. The situation echoes other recent national seismic shifts —the Great Recession and Affordable Care Act—that drove changes like increased healthcare consolidation and value-based care. Patients, many reluctant to seek care at medical facilities or even […]

Synergy Between AI and Digital Platforms for PBMs; Driving Value-Based Programs

Both CVS Health and Express Scripts have recently expanded value-based care programs aimed at improving patient outcomes and reducing the high costs for treatments associated with oncology and cardiovascular disease, respectively. PBMs and payers believe that with seamless access to patient data, new technology such as artificial intelligence and predictive analytics will be critical in […]

What CVS and Anthem Gained From The Centene-WellCare Deal

CVS expanded through IlliniCare Health Plan The combined carrier formed by Centene and WellCare will have a greater market share with respect to number of enrolled lives. Centene and WellCare had to divest some of their entities to go ahead with the deal. Centene signed a definitive agreement with CVS to divest its Illinois health plan […]