- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Tavenner Withdraws Fractious Part D Changes
Under pressure from the industry and Congress, the Centers for Medicare & Medicaid Services is withdrawing several proposed changes to the Medicare drug program, but still charging ahead with others that could prove disruptive.
Under pressure from the industry and Congress, the Centers for Medicare & Medicaid Services is withdrawing several proposed changes to the Medicare drug program, but still charging ahead with others that could prove disruptive.
In a large batch of Medicare Part D proposed regulations first published in January, CMS announced plans to end three protected classes of drugs, standardize preferred pharmacy networks, extend negotiated drug pricing across the program and limit the number of plans available in a region, among other things the agency argued would collectively help save $1 billion over five years.
Those proposals and others drew criticism from various corners of Congress and the health, insurance and pharmaceutical industries, especially the elimination of the protected classes of antidepressants, antipsychotics and immunosuppressants and a new interpretation of the Part D “non-interference” clause that would give every pharmacy the ability to contract with plans under preferred terms and conditions.
Read the full story here: http://bit.ly/1iAmp2S
Source: Healthcare Payer News
How Value-Based Care With Provider Enablement Improves Maternal and Infant Outcomes in Medicaid
June 12th 2025Supported value-based care improves prenatal care while reducing neonatal intensive care unit stays, preterm birth rates, low birth weight rates, and costs for mothers and infants.
Read More
Laundromats as a New Frontier in Community Health, Medicaid Outreach
May 29th 2025Lindsey Leininger, PhD, and Allister Chang, MPA, highlight the potential of laundromats as accessible, community-based settings to support Medicaid outreach, foster trust, and connect families with essential health and social services.
Listen
New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
Listen
