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The Next HIX Challenge: Formulary, Network Comparison Tools
Left as-is, current exchange formuarly and network search technology has the potential for a lot of consumer dissatisfaction and backlash.
Left as-is, current exchange formuarly and network search technology has the potential for a lot of consumer dissatisfaction and backlash.
In just under half of the public exchanges, it is “difficult or impossible” for shoppers to figure out which drugs are covered by health plans, researchers at Avalere Health found in a study of 12 state-based and five federally-run exchanges.
In eight exchanges, plan formularies are either difficult to access, such as in Florida and New York, or almost impossible to find, with no online links to the drug lists in California, Massachusetts, Oregon, Rhode Island, Washington and Washington D.C.
In nine of the exchanges studied, formularies are at least moderately accessible, Avalere researchers found in the study, funded by Pfizer.
Read the full story here: http://bit.ly/1rObaF0
Source: Healthcare Payer News
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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Neurologists Share Tips for Securing Patient Access to Gene Therapies
March 19th 2025Tenacious efforts at every level, from the individual clinician to the hospital to the state to Congress, will be needed to make sure patients can access life-saving gene therapies for neuromuscular diseases.
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The Impact of Cost Sharing on High-Value Care
March 14th 2025Michael Chernew, PhD, professor of health care policy and director of the Healthcare Markets and Regulation Lab, Harvard Medical School, shares how cost-sharing policies shape access to critical health care services and influence value-based insurance design.
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A Focus on MAHA, Lasting Changes to Health Care Programs for Trump’s Second Term
March 13th 2025The second Trump administration is expected to bring changes to Medicaid, Medicare Advantage, and the health insurance exchanges, as well as highlight the Make America Healthy Again (MAHA) movement, speakers at the Value-Based Insurance Design Summit said.
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