Individual states are on the frontline for implementing the recently passed Patient Protection and Affordable Care Act. A few of the first pieces of that landmark legislation include the implementatio…
Hepatitis C virus (HCV) is the leading cause of end-stage liver disease and hepatocellular carcinoma. Increasing diagnosis and treatment rates, and substantial unmet need combine to make HCV a high-gr…
The practice known as “academic detailing,” which aims to provide physicians with a more complete, evidence-based, and presumably unbiased education about what specific drugs will do, has sp…
Health reform doesn't make its biggest splash until 2014, but health plans are getting their feet wet this year having to comply with numerous new mandates in the next 12 months. Among the most ch…
The Michigan agency that oversees Medicaid has elected to expand the pharmacy carve-out for psychotropic drugs, taking the responsibility away from the state's Medicaid HMOs. The advantage to the…
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…
In Georgia and Louisiana, state government is the largest employer and insures the largest group of people. In both states, cost saving changes are under way. Louisiana is looking at privatizing its s…
A change in pharmacy benefit management at California's largest health insurer paves the way for a gradual shift in focus to home delivery of medications, particularly generics. Analysts say the p…
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…
Employers in North Carolina and South Carolina are turning to so-called hybrid plans to help them continue to offer coverage in one of the regions worst hit by job losses. The hybrid plans combine fea…
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…
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…