Tracey Walker

PBM services add a different dimension to traditional healthcare, promoting increased industry innovation and broader adoption of value-based drug benefit designs.

The FDA is considering behind-the-counter (BTC) medication availability and how it might improve access to safe and effective drugs.

A national examination of disease prevalence among Medicaid beneficiaries underscores ways that managed care plans can rethink care management approaches for high-need, high-cost beneficiaries with multiple chronic conditions.

An important component of the legislation that has not received a lot of press to date has been the Health Care and Quality Cost Council (HCQCC) which was established by the same health reform law that created the Connector.

Perhaps it's no coincidence that former historian Jon Kingsdale, PhD, finds himself overseeing one of the most progressive healthcare initiatives in the country, the Massachusetts Commonwealth Health Insurance Connector Authority. The Connector facilitates the purchase of health insurance for individuals and small businesses across New England.

Medicare is a difficult market to be in and is going to get even more challenging in the next few years, experts say.

Increased insurance coverage should boost demand for medical services which would highlight concerns about access to medical care, particularly outside of Boston.

Detroit's Big Three automakers are considering shifting future retiree healthcare costs to union-controlled trust funds and are eyeing a new contract between Goodyear Tire & Rubber Co. and the United Steelworkers (USW) union.

Wal-Mart and the Service Employees International Union (SEIU) have formed what industry watchers have called an "unusual" partnership to push for quality, affordable healthcare.

Over the next few years, more health plans and employers will investigate covering the physician-administered injectable drugs under the pharmacy benefit as a way to control the costs and manage appropriate utilization, says Kathryn Lindhorst Canaday, PharmD, director of pharmacy analysis, Pharmaceutical Strategies Group (PSG), based in Dallas.

Oncology therapy has the potential to become the single leading category promoting drug spending growth, however, the class of drugs is rife with challenges for plans and employers.

William Copeland JR.'s assessment of the United States' healthcare system is crystal clear: The system is a financial and structural mess.

WITH changes on Capitol Hill and at the state level after 2006 mid-term elections, experts are expecting more focus on broadening Medicaid coverage.

Besides an ongoing trend of mergers and acquisitions, other issues are shaping the PBM market, say experts.

Jerry Rhoads, CEO, Caregiver Management Systems, believes the long-term-care aspect of the U.S. healthcare system is woefully lacking and in desperate need of a major paradigm shift-which is what he and his company have been attempting to do for the past 15 years.

In his job description as executive director of the managed care division for Cleveland Clinic, Michael McMillan is accountable for business relationships with health plans and employers. McMillan is focused on making the Clinic-one of U.S. News & World Report's top three hospitals-available to members of every health plan and managed care organization.

The rise in popularity of consumer-driven healthcare (CDHC) will challenge HMOs to be at the top of their game, say industry watchers.

Conventional wisdom says that to introduce real change, you need to bring in someone from outside. Jack LeFort, CEO and founder of Connextions Health, a company in the emerging field of consumer-directed healthcare (CDHC), has brought a similar paradigm shift to healthcare from the outside.

When it comes to public health, experts agree: Fail to plan and the health plan fails.

Recent data supports the success of Prescription Drug Plans (PDPs) under Part D.

National Reports-New Orleans officials recently announced that they believe the city has reached half of its previous population prior to Hurricane Katrina. Some of the city's hospitals have not reopened, and many doctors and allied health professionals have not returned to the city.

The growth in high-cost injectable and infusion therapies for the treatment of chronic illnesses is a significant management issue for pharmacy benefit managers and payers, experts say.

National Reports-Cost is a factor in employee enrollment rates, but lower-cost, exclusive-provider plans are less commonly offered, according to a recent survey conducted by the Agency for Healthcare Research and Quality (AHRQ).

Washington, D.C.-Robert Kolodner, MD, has been named by the Department of Health and Human Services (HHS) as the interim national coordinator for health information technology, assuming the position vacated by David Brailer, MD, PhD, who resigned in May.

November DTR Analysis: Medicare HMO enrollment varies dramatically

What title and job credentials are embossed on the business card of David J. Brailer, MD, PhD, the new National Health Information Technology Coordinator?

Lincolnshire, Ill.- Healthcare cost increases, while high, are moderating because of decelerating cost trends, according to Hewitt Associates.

Information creates opportunity . . . opportunity to realize value in the products we buy and the services we receive. A phenomenon in retail shopping took place about 10 years ago when advances in information technologies placed consumer information at our fingertips, allowing us to compare products in an endless number of ways.

Executives will need to ... craft a whole-person care plan.

DM plays a key role in the evolution of specialty pharmacy