HealthLeaders-InterStudy has prepared an executive briefing.
New York health plans are under more pressure than ever to keep a lid on rates, but their requests for premium increases have been curtailed under the new prior approval law. As one alternative, carri…
Commercial markets in Colorado and Nevada have been shaken up by expansion of HMOs and, in the case of Las Vegas, new market entrants. At the same time, local brokers say employers are not likely to s…
The early returns from a massive valued-based benefit design initiative in Kansas City have led to five new pilots nationwide. In concert with its PBM, CVS Caremark, the Kansas State Employee Health P…
Tennessee Gov. Phil Bredesen likely will not have to enact draconian cuts to TennCare this year, but is still pursuing two methods to trim the pharmacy program in ways that will cut into pharmaceutica…
Brokers predict that enrollment for 2010 will be flat and that insurers will bump up their revenue with premium increases and changes in benefit designs. Health plan enrollment went down only slightly…
In an effort to curtail the growing cost of specialty drugs, Regence has developed a new benefit design with a standard and extended six-tier formulary that combines medical and prescription drug bene…
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…
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…
Minnesota health plans are facing the specter of rising specialty drug costs and are implementing a variety of strategies to control those costs, including shifting specialty drugs from the medical be…
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…
Health plans have begun to put generic dispensing goals into their pay-for-performance packages with some health plans. Advocate Physicians, which works closely with its payors, instituted a focused g…