Employers Newly Committed to Offering Insurance
Just 3 years ago, large employers were considering no longer offering insurance and instead shifting their employees to the Affordable Care Act (ACA)’s marketplaces. However, employers have since changed direction, with companies newly committed to maintaining insurance coverage, reported Kaiser Health News. This year, 92% of employers in a survey said they were very confident they would be offering health plans in 5 years, compared with just 25% back in 2014. The uncertainty of the ACA isn’t the only reason for the change of heart—the strong economy means employers are offering insurance as a way to get the best workers.
CVS Sued Over Drug Costs
A California woman is accusing CVS of charging customers paying through insurance more money for prescription drugs than the medicines actually cost. According to Bloomberg, the plaintiff said she once paid $166 for a generic drug that would have only cost $92 if she had paid in cash. CVS denies any wrongdoing and explained that the copays are determined by pharmacy benefit managers. There are at least 16 other lawsuits targeting drugstores for these copay “clawback” practices, or situations when patients pay a copay that exceeds the actual cash value of the drug.
Declaring a State of Emergency
The president’s opioid panel recommended declaring the opioid epidemic a state of emergency, but President Donald Trump has declined to do so. STAT explains that it was unclear what declaring a state of emergency for the country might have meant. There are examples in the states, however, where the move has allowed officials to expand use of naloxone or implement new prescription monitoring guidelines. A declaration of a national emergency might mean little more than “stirring officials to act with authorities they already have.”
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
Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
Listen
Integrated CKD Care Model Cuts ED Visits by 30%, Boosts Specialized Treatment
April 21st 2025An analysis of an interdisciplinary care model for managing chronic kidney disease (CKD) shows hospital admissions dropped by 26% and emergency department (ED) visits decreased by 30% after clinic initiation.
Read More