Healthcare reform will be less of a game-changer in the TriState, at least for New York and New Jersey, which already ban medical underwriting, exert some controls over insurer rates and benefit plans…
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…
Value-based insurance designs, medical homes and Medicaid reform, as well as the federal health reform law, are affecting the healthcare landscape in Georgia, Louisiana and Alabama. Large employers in…
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…
Parkinson's disease (PD) is one of the most common neurodegenerative diseases in the elderly. The launch of several new therapies and new formulations of key brands will drive market growth, but g…
One by one, the Blue Cross and Blue Shield plans in Pennsylvania are changing their underwriting practices to better compete with for-profit insurers they say are cherry picking the best health risks…
Health plans nationwide have been struggling to retain membership amid the ongoing economic crisis. Minnesota state health plans have responded by rolling out new plan designs targeting the growing in…
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…
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…
The economy has inspired fewer bold moves and more fiscal caution in the TriState health insurance market, both in government and the private sector. Connecticut is experiencing a seismic shift in its…
While lawmakers in Washington, D.C., fight over a problematic national healthcare reform bill that includes an individual mandate, the only state in the nation with such a law in placeÑMass…
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…
Ohio has decided to carve out Medicaid pharmacy in anticipation of the passage of a new federal law, the Drug Rebate Equalization Act. The Act will give managed care companies the same rebates – aroun…