Chronic pain is a multi-billion dollar market saturated with well-established branded and generic analgesics that are only partially effective. While drugs with novel mechanisms of action that offer g…
Independence Blue Cross is one of the state’s largest health insurers, but is one of the last to cover its members’ self-injected specialty drugs under the medical benefit. But that’s changing in 2010…
In what could end up as a budget buster for the state, Maryland's Medicaid rolls went up by more than 90,000 from July 2008 to October 2009. The recession accounted for some of that rise just as…
Blue Cross and Blue Shield of Kansas City has engaged a medical home pilot with TransforMED, bringing new technologies to 13 medical practices in its operating regions. The practices can build the med…
The individual health insurance markets in New York and New Jersey are a study in contrasts, despite the fact both are highly regulated to guarantee residents a certain level of coverage. New Jersey&#…
Florida Medicare Advantage plans are reacting to reduced reimbursements by scaling back benefits and raising costs to their HMO members for 2010. The change, which comes as the federal government is c…
Scott & White Health Plan has leveraged its vertical integration to keep proton pump inhibitor costs at a fraction of the national average. For the first time, Texans who have received out-of-netw…
Massachusetts' largest health insurer, Blue Cross Blue Shield, is embracing one of the latest trends in pharmacy benefit management, that of value-based benefit design. The Boston-based health pla…
Group Health's governance as a nonprofit member-owned cooperative has attracted national attention recently as healthcare reform discussions in Washington DC look toward insurance cooperatives as…
With all eyes focused on the national healthcare reform debate, California is already tackling many of the same thorny issues raised by policymakers. Healthy San Francisco, the city/county’s 2-year-ol…
A new agreement between Caterpillar and Walgreens could point the way to a change in drug dispensing for large employers. Under this agreement, Caterpillar contracts directly with Walgreens, where 100…
Kansas Medicaid members could face a preferred drug list and a streamlined prior authorization process, which could widen the number of therapeutic classes the state covers. These changes are borne ou…
With 62 million cases of osteoporosis and osteopenia in the United States and a U.S. market of over $3.8 billion, few brands are competing for a very large appropriation of healthcare dollars. Major…
Beginning in January 2010, Tennessee plans to test a statewide database that will include claims data from claims paid by most of the payors in the state. The database is designed to improve transpare…
Wisconsin state officials are dictating to state HMOs that changes be made in how care is delivered in the state's Medicaid/BadgerCare Plus program. Faced with unacceptable HMO quality scores as w…