Healthcare Reform Blog

Fresh U.S. healthcare insights from expert analysts on Healthcare Reform, ACOs, Exchanges, Medicaid, Medicare, regional and national trends…and much more

Contributors: Tim Blackstock
Topics: Obesity, Orexigen, Mysimba, Contrave, Saxenda, "Novo Nordisk", "Takeda Pharmaceutical", approvals

…there are none for ages and then several come along at once. In the United States, physicians managing obese patients were essentially only able to prescribe Roche’s Xenical (orlistat) and phentermine (and other noradrenergic anorectic agents) for years, and then Arena Pharmaceutical/Eisai’s Belviq (lorcaserin) and Vivus’s Qsymia (phentermine/topiramate fixed-dose combination [FDC]) were approved in June and July, respectively, during 2012.

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Posted on: 3/27/2015 2:53:49 PM

Sheri SellmeyerContributor: Sheri Sellmeyer
Topics: ACA, Aetna, Anthem, BCBS of North Carolina, Centene, exchanges, PreferredOne, UnitedHealth Group

Now that the dust has settled on year two of open enrollment for the health insurance exchanges, it’s a good time to bust a few myths about the program. Read more.
Posted on: 3/26/2015 4:54:57 PM

Sarah WilsonContributor: Sarah Wilson
Topic: ACA, “health plans”, MLR, “narrow networks”, ACOs, exchanges

The healthcare industry continues to become more consolidated, especially as health systems and hospitals form larger, more integrated health systems through mergers and acquisitions. While the Affordable Care Act has encouraged this trend, the Federal Trade Commission has put the brakes on consolidation plans, particularly deals that threaten prices and competition. Read more.
Posted on: 3/24/2015 10:39:21 AM

Merk CherryContributor: Mark Cherry
Topics: Cadillac Tax, exchange subsidies, individual mandate, narrow networks, Obamacare, Patient Protection and Affordable Care Act, provider consolidation

For its entire five-year history, the Patient Protection and Affordable Care Act has faced constant criticism, stoked by pundits and pols who churn anti-Obamacare sentiment in an effort to score points with consumers/constituents. Read more.
Posted on: 3/24/2015 10:29:39 AM

Ric GrossContributor: Ric Gross
Topics: Arkansas, Indiana, “Medicaid expansion”, Michigan, “Patient Protection” and “Affordable Care Act”

When the Patient Protection and Affordable Care Act passed five years ago, on March 23, 2010, it dramatically changed the Medicaid landscape across the United States—just not in the way lawmakers intended.

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Posted on: 3/24/2015 10:26:26 AM

Paula WadeContributor: Paula Wade
Topics: ACA, “health plans”, MLR, “narrow networks”, ACOs, exchanges

The Affordable Care Act of 2010 has done much more than extending healthcare coverage to millions of Americans – its market reforms have re-defined what health insurance is (and isn’t) for individuals and small groups. Read more.
Posted on: 3/23/2015 3:51:30 PM

Bill Melville Contributor: Bill Melville
Topics: CoverOregon, MNSure, “Connect for Health Colorado”, "Affordable Care Act"

More than 8 million enrollees with subsidies can’t be wrong – unless the U.S. Supreme Court says so. Read more.
Posted on: 3/23/2015 3:43:54 PM

Carolyn McMeekinContributor: Carolyn McMeekin
Topics: ACA, healthcare reform, Medicaid, ACO, exchanges

Five years ago, DRG analysts gathered in a conference room and watched as healthcare reform in the United States became a reality.

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Posted on: 3/23/2015 10:27:02 AM

Lyda PhillipsContributor: Lyda Phillips
Topics:  Biologics, biosimilars, hepatitis C, Pharmacy Benefit Management Institute, PBMs, Sovaldi, specialty drugs

Whether it’s biosimilars, hep C or PCSK9, reining in costs or excluding Sovaldi, the buzz of the 2015 Pharmacy Benefit Management Institute conference in San Antonio was biologics.

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Posted on: 3/19/2015 11:42:15 AM

Joyce CaruthersContributor: Joyce Caruthers

Topic: UnitedHealth Group, Care Improvement Plus, WellCare Health Plans, Touchstone Health Partnership, Centene, First Medical, Health Plan, BlueCross BlueShield of South Carolina, Kaiser Permanente, Group Health Cooperative, Gundersen Health Plan, Martin’s Point Generations

The Centers for Medicare & Medicaid Services’ star ratings system is having the intended effect. The number of Medicare Advantage and Part D plans that received low-performing icons (LPIs) decreased from 39 in 2014 to just seven in 2015 and some carriers with low star ratings are voluntarily leaving the market.


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Posted on: 3/12/2015 9:28:04 AM

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