MHE March 2023

Commercial plans haven’t traditionally covered hearing aids.

This part of the month's cover story series features Suzanne Delbanco, Ph.D., M.P.H., executive director of the Catalyst for Payment Reform, who has the provocative suggestion of flipping physician payment so primary care physicians are paid more, not less, than specialists. “We spend so much more on specialists than we do on primary care. While a specialist can help people who are already ill, primary care doctors can help people from becoming ill,” she says.

This part of the month's cover story series features Ivan Jarry, CEO of Obviohealth. According to Jarry, companies like his that run decentralized clinical trials can solve many of the problems that bedevil clinical trials, making them cheaper, faster and more inclusive and their results more reliable. This months cover story shines a light on the companies, trends and ideas that are shaking things up and reshaping the contour of how healthcare is paid for and delivered.

This part of the month's cover story series features private equity and how it's coming for primary care. Jane Zhu, M.D., M.P.P., of Oregon Health & Science University shares that private equity takes advantage of economies of scale to make things more streamlined, then move onto the next market or specialty. This months cover story shines a light on the companies, trends and ideas that are shaking things up and reshaping the contour of how healthcare is paid for and delivered.

This portion of the month's cover story series spotlights PBM EmsanaRx, a branch of Purchaser Business Group on Health (PBGH), and its President and CEO, Elizabeth Mitchell, who explains that EmsanaRx differs from other PBMs because they use what PBGH calls a waste-free formulary. This months cover story shines a light on the companies, trends and ideas that are shaking things up and reshaping the contour of how healthcare is paid for and delivered.

As ideas about what constitutes healthcare have expanded, so has the involvement of newcomers such as Best Buy.

Take a look into this month's cover story series of the companies, trends and ideas that are shaking things up and reshaping the contour of how healthcare is paid for and delivered. Below spotlights business process management firm Sagility and its chief growth officer, Sohail Djariri, who breaks down payment integrity when it comes to fraud detection.

Take a look into this month's cover story series of the companies, trends and ideas that are shaking things up and reshaping the contour of how healthcare is paid for and delivered. Below spotlights Alexander Oshmyansky, M.D., Ph.D, and his company he founded, Cost Plus Drug, also known as Mark Cuban Cost Plus Drug Company.

The start of the COVID-19 pandemic was marked by a regulatory rush to enable digital health delivery. Now the industry wants those changes made permanent.

Pharmacy benefit managers say they exclude high-cost drugs and have alternatives on their formularies. Critics say exclusions narrow patient options and may put effective medication financially out of reach.

Research stalled for decades after deaths in a 1960s trial. Now Pfizer and other companies are reporting results for a vaccine against respiratory syncytial virus infections.