VBID to end Dec. 31, 2025 CMS will terminate the Medicare Advantage Value-Based Insurance Design (VBID) model at the end of 2025. The reason? Its "substantial and unmitigable costs" to the Medicare Trust Funds, totaling $2.3 billion in 2021 and…
Embedding pharmacists enhance primary care Embedding pharmacists in primary care teams boosts access, mitigates physician shortages, and improves outcomes, according to the authors of a Health Affairs Forefront piece. About 69% of visits involve medication, and PCPs spend approximately 37%…
Lawsuit updates: GoodRx and PBMs sued; Walgreens settles Coupon aggregator GoodRx and PBMs including CVS Caremark and Express Scripts have been hit with at least three class action lawsuits accusing them of working together to suppress reimbursements to small pharmacies…
NYT does deep dive into PBMs. It’s not pretty The New York Times has set out to explain how PBMs “prioritize their interests, often at the expense of patients, employers and taxpayers.” PBMs largely escape attention “because they operate in…
CMM primer defines and outlines benefits of CMM Comprehensive medication management supports population health and value-based care performance, and a recent LinkedIn post from the Population Health Alliance spells it out. CMM can improve quality outcomes and reduce costs among…
What’s happening with telehealth? Walmart's decision to shutter its health clinics and virtual care services isn’t just a blow to retail health; it has profound implications for telehealth. And it’s happening at a critical time. Optum is shutting down its…
Lawsuit: Drugmakers overcharged 340B participants millions According to a recently unsealed lawsuit from Adventist Health, some of the world’s largest pharmaceutical companies that participate in the 340B drug discount program overcharged the federal government and numerous hospitals by hundreds of…
SOTU address promises cap on OOP drug cost President Joe Biden’s State of the Union Address Thursday included some sweeping proposals, including extending a $2,000 cap on out-of-pocket drug costs to all Americans. Other proposals included expanding the number of…
Employee sues J&J over PBM costs A Johnson & Johnson employee is suing the company for allegedly violating ERISA by mismanaging prescription drug benefits. The lawsuit accuses the company of paying inflated costs for generic drugs to its PBM, Cigna’s…
GTMRx releases latest CMM evidence document The Get the Medications Right Institute has released its summary of research on comprehensive medication management (CMM). The December 2023 review, “The Outcomes of Implementing and Integrating Comprehensive Medication Management in Team-Based Care: A…
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