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Exploring Reference-Based Pricing as a Method for Lowering Healthcare Costs
Reference-based pricing has been touted as a way to contain healthcare costs while ensuring quality of care. We talk with with David Henka, chief executive officer of ActiveRADAR, to dig deeper into how the method is used in practice and what program results have shown.
Reference-based pricing has been touted as a way to contain healthcare costs while ensuring quality of care. When implemented, health plans or employers compare the costs of all brand-name and generic drig options within a certain therapeutic category and identify the lowest cost options. From there, copays are adjusted to encourage the use of the lowest cost alternatives, with plans covering the cost of a drug or service up until the reference point.
With research showing that these programs can reduce costs by an average 20% each year, we sat down with David Henka, chief executive officer of ActiveRADAR, to dig deeper into how the method is used in practice and what program results have shown.
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Navigating Sport-Related Neurospine Injuries, Surgery, and Managed Care
February 25th 2025On this episode of Managed Care Cast, we speak with Arthur L. Jenkins III, MD, FACS, CEO of Jenkins NeuroSpine, to explore the intersection of advanced surgical care for sport-related neurospine injuries and managed care systems.
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ERISA Industry Committee Sues Minnesota Over PBM Law
January 3rd 2025The Employee Retirement Income Security Act (ERISA) Industry Committee filed a legal challenge against the Minnesota Department of Commerce, arguing that Minnesota’s Pharmacy Benefit Manager (PBM) Licensure and Regulation Act illegally interfered with employer-sponsored health plans by restricting plan design options and increasing costs.
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Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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Contributor: The Diabetes Vendor Resource Guide—A Useful Directory for Employers
November 13th 2024Employees living with diabetes often face unique challenges, such as managing blood sugar levels, balancing medication, and preventing complications, all while maintaining their professional responsibilities. This condition can lead to increased absenteeism, reduced productivity, and rising health care costs.
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