HORIZON Health Ventures: February 2017

Tuesday, February 28, 2017

Unlocking Data Insights in a Few Clicks

Today's blog features the Express Scripts MediCUBE that is changing the way that their clients are leveraging real-time data for better decision making.

"MediCUBE® is Express Scripts’ advanced diagnostic and data mining platform that integrates medical and pharmacy claims data to better understand prescriber, pharmacy and patient trends."

Watch the full video on how it works HERE!

HORIZON Health Ventures is a healthcare cost management solutions company used by insurance brokers, employee benefit consultants, third-party administrators, insurance companies, and associations, to bring proven thought leadership and strategy to the management of their clients healthcare costs. To learn more about HHV and their services, please visit http://horizonhealthventures.com/

Friday, February 24, 2017

Trump Administration Gives One Year Extension to Non-ACA Compliant Plans

Courtesy of Modern Healthcare, we're bringing you breaking news this morning. According to Harris Meyer of Modern Insurance, "The Trump administration will allow insurers and consumers to extend for an additional year individual and small-group health plans that do not comply with the Affordable Care Act's coverage rules."

This new CMS guideline allows grand-mothered plans to operate until December 31st, 2018.

Check out the full article HERE!

HORIZON Health Ventures is a healthcare cost management solutions company used by insurance brokers, employee benefit consultants, third-party administrators, insurance companies, and associations, to bring proven thought leadership and strategy to the management of their clients healthcare costs. To learn more about HHV and their services, please visit http://horizonhealthventures.com/

Wednesday, February 22, 2017

Unpopular Changes to the Primary-Care Model

Virgil Dickson of Modern Healthcare reported that the new change to the way that some providers are reimbursed under the new primary-care model could deter providers from joining the Medicare initiative.

Dickson states, "The model looks to improve health outcomes and lower costs not only for Medicare beneficiaries, but for consumers covered by commercial plans and those in other coverage options, such as Medicare Advantage."

Check out the full article HERE to learn more!

Thursday, February 16, 2017

Anthem Seeks Restraining Order Against Cigna

There is a major headline surfacing in the healthcare industry this week. Cigna ended their merger with agreement with Anthem on Tuesday. Cigna released that they are seeking over $13 million in damages from Anthem on top of the $1.85 billion break-up fee that was outlined in their initial contract.

Livingston writes, "The Bloomfield, Conn.-based insurer said the planned $54 billion merger, which was blocked by a federal district court last week on anti-competitive grounds, “cannot and will not achieve regulatory approval” and that calling it off is best for its shareholders."

Shelby Livingston of Modern Healthcare wrote a tactful summary of this developing story. Read the full article HERE!

Tuesday, February 14, 2017

What Really Drives Drug Spending?

Drug Channels recently reported that Express Scripts released its 2016 Drug Trend Report for the commercial market. This new report deconstructs the year-over-year changes in drug spending into two primary components: Unit Costs and Utilization.

The article states, "A hot topic is the possibility that Medicare could replace PBMs and begin direct negotiations with manufacturers. But any savings will need to come from much more aggressive restrictions than those used by Part D plans now."

Put this interesting read on your list to look through today. Find the full article HERE!

Thursday, February 9, 2017

Health Care Costs Top Concern for American Families

Jack Craver of Benefits Pro recently reported that the number one cause of concern for American families is the rising cost of healthcare. This concern is ranked higher than job security and unemployment as well as being able to pay bills and groceries.

Craver explains, "In recent years, whoever is in power politically has been blamed by the opposition for the rising cost of health care. While premiums did not rise as dramatically under President Obama as they had his predecessor, President George W. Bush, his health care overhaul did not stop prices from going up — in many cases significantly — a fact Republicans seized on in the last two election cycles."

Republicans are now in the process of repealing the Affordable Care Act without throwing millions of people off coverage or driving premiums up even higher. Check out the full article HERE!

Tuesday, February 7, 2017

Fighting Back Against Irresponsible Drug Pricing

Today's blog features a recent post from Express Scripts that boasts that ESI's efforts were able to put medicine within reach for payers and patients effectively held the 2016 rate in prescription drug spending to just 3.8%, which translates to a 27% decrease from 2015. Drug prices were the number one concern of payer and policy makers so it confirms that ESI's solutions protected these patients.

Find the full article to learn about ESI's continued efforts to lower drug prices by clicking HERE!

By practicing pharmacy smarter, we uniquely make medicine more affordable and accessible for patients. We do this by driving down drug prices and ensuring appropriate use of clinically-proven medicine, while helping employers remain competitive. - See more at: http://lab.express-scripts.com/lab/insights/industry-updates/fighting-back-against-irresponsible-drug-pricing?ec_as=cdcb989ed03f4d5d8efeb9901d08a2a7#sthash.mkGBVLQ5.dpuf

Thursday, February 2, 2017

What is a PBM?

What exactly is a pharmacy benefit manager and what do they do? Check out today's video brought to by Express Scripts that answers that very common question!

View the full video HERE!