As a paying member of AMCP from the very beginning, I have watched this organization grow into an effective voice for managed care pharmacy. By choosing leaders who truly understood the issues facing pharmacy practice in a health plans and PBM environment, AMCP has provided real ‘value’ to its members for 25 years.
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According to The Hill’s Elise Viebeck President Obama is receptive to combining Medicare Part A (in-patient hospital) and Part B (outpatient and doctor) deductibles, into a single deductible just like every other insurance scheme in the US. Predictably those to his left complained, maybe because Virginia’s Eric Cantor also likes the idea.
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This will be the title of my instructional pamphlet that I envision sitting in a doctor’s office, among other great pamphlets such as “Talking to Your Kids about Drugs” and “Depression: Not Just a Hole in the Ground”.
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Health insurance issuers are generating enough fodder for a good guessing game. Will Obamacare increase rates for individual insurance or not? And if so, will the increase be modest or catastrophic. Writing in the April 25 edition of the Washington Post, Ezra Klein reports that the Blues plan that serves the national capital area is warning of big increases in individual premiums. The cause?
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The March 28 edition of Medicare Advantage News cites a possible trend for provider organizations to sponsor their own Medicare Advantage plans. In the waning days of the old Medicare+Choice program, many provider-sponsored plans came on hard times, so this may seem like an unusual reversal. However, Medicare Advantage lives up to its name, and offers advantages to sponsors as well as members.
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It is common practice for commercialization teams to develop and test various “value props” for new products. Teams look to determine the stakeholders involved in the utilization and management of the product, along with the patient types most likely to benefit from the therapy. This is a pretty standard process, with internal groups made up of marketing, clinical, managed markets middle level managers, along with health outcomes and possibly distribution.
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Last Friday CMS’s Medicare Learning Network released some details on how the sequester will impact Medicare fee-for-service. By extension we see some implications for what it means to Medicare Advantage (MA). The CMS notice offered the following:
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The bad news in the 45 day notice is proposed payment cuts to Medicare Advantage plans for 2014 and big changes to risk adjustment but there is also good news about the reduction in almost all of the Part D benefit parameters.
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I hope you enjoyed the State of the Union (SOTU) address as much as I did -- it's the Super Bowl of policy geeks. I saw it as an effective rallying tool around a number of the President's goals that will deeply challenge the GOP opposition, like an increase in the minimum wage and immigration reform. But it was the utter lack of any new ideas for Medicare that struck me -- and definitely no olive branch to House Budget Committee Chairman US Rep. Paul Ryan (R-WI) on premium support. So where now for Medicare?
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The Congressional Budget Office (CBO) released its new economic outlook yesterday with some interesting predictions on the launch of the Affordable Care Act’s health insurance marketplaces (exchanges). But it was some of its Medicare findings that blew my hair back last night:
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We’re coming up on the 7th anniversary of the last Senate confirmation of a CMS administrator. Seven years! There have been a succession of interim or acting administrators since, most notably the brilliant, visionary, and ultimately polarizing Don Berwick. Politico has a great piece out today on why our favorite agency has been in the wilderness for so long, and the implications of such long-term “temporary” leadership.
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With all the activity underway across the states, you’d think we were less than 10 months away from when health plans in the Exchanges begin enrolling or something. Oh wait…HOLY CRAP we’re less than a year from launch! The game is on, friends:
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