Managed Care State of the Industry 2018

Simmering tensions in the pharmacy benefit management (PBM) industry have turned into fault lines. The PBMs challenging the "big three" have formed a trade association. Purchaser coalitions want change. The head of the industry's trade group says inherent marketplace friction has spilled over into political friction.

In this episode of the "Meet the Board" podcast series, Briana Contreras, Managed Healthcare Executive editor, speaks with Ateev Mehrotra, a member of the MHE editorial advisory board and a professor of healthcare policy and medicine at Harvard Medical School. Mehtrotra is also a hospitalist at the Beth Israel Deaconess Medical Center in Boston. In the discussion, Contreras gets to know Mehrotra more on a personal level and picks his brain on some of his research interests including telehealth, alternative payment models and price transparency.

The report from the American Medical Association evaluates health insurer market share at the metropolitan statistical area level and national level.

In this week’s episode of Tuning In to the C-Suite podcast, MHE Associate Editor Briana Contreras interviewed VillageMD’s Senior Medical Director of Village Medical at Home, Dr. Tom Cornwell. Dr. Cornwell discussed the main benefits of primary care at home, which includes the benefit of cost savings for patients, maintaining control of hospital readmissions and others. Dr. Cornwell also noted what has changed in the industry of at-home care and if there has been interest from payers like insurance companies and medicare in the service.

Healthcare leaders discussed digital health during the recent American Heart Association conference, outlining the potential and pitfalls. Often, setbacks aren’t related to the technology.

The Biden administration is looking at a policy change that would enable more older Americans to get oral and injectable medications.