Healthcare Reform Blog

Laura BeermanContributor: Laura Beerman
Topics: ACOs, Orphan Diseases, MMS

It’s been a month since DRG’s Managed Markets Summit, but there’s a conversation I can’t forget: if and when ACOs will affect the rare/orphan drug landscape.

The question was posed by a conference attendee between sessions. As my new friend and I talked through pulmonary hypertension and the rather busy market space for such a rare condition, my short answer was that the immediate impact of ACOs on companies like his would be a longer time coming. And that the effect was likely to be more indirect than direct. Why? Read more.
Posted on: 10/28/2013 9:39:58 AM

Chris SilvaContributor: Chris Silva
Topics: Medicare Advantage, Part D, CMS, Star ratings

With all the craziness early October brought with health exchanges, website glitches and the federal government shutdown, it was easy to overlook the start of the new seven-week enrollment period for Medicare Advantage and Part D plans. Read more.
Posted on: 10/24/2013 8:59:54 AM

Jane DuboseContributor: Jane Dubose
Topic: Exchanges, ACA, Humana

Let’s assume the federal health marketplace website actually starts working efficiently, the state-run exchanges clean up their bugs, and every other star aligns for the successful launch of exchanges in 2014. Who will be the enrollment winners among health plans?
Read more.
Posted on: 10/23/2013 6:09:34 AM

Bill MelvilleContributor: Bill Melville
Topics: ACA, Exchanges, Medicaid, Obama

In President Obama’s Oct. 21 address on the Affordable Care Act and persistent enrollment glitches for the new marketplaces, it was tempting to say the White House gathered all the people for the Rose Garden speech (about 10) who successfully signed up through to stand behind the president.

Read more.
Posted on: 10/21/2013 4:51:55 PM

Chris LewisContributor: Chris Lewis
Topics: Covered California, Exchanges, Affordable Care Act

More than two weeks into open enrollment, shoppers in the Covered California insurance exchange lack access to two critical pieces of information to help them select a plan: a directory of in-network providers and the drug formularies.
Read more.
Posted on: 10/21/2013 1:56:22 PM

Holly FultsContributor: Holly Fults
Topics: Employers, narrow networks, ACOs, quality

Retail giants Walmart and Lowe's have announced a new healthcare benefit for their employees: no-cost knee and hip replacements. As of Jan.1, care and consultations for the procedures will be covered at 100 percent, with no copays or deductibles.
Read more.
Posted on: 10/21/2013 10:20:52 AM

Sheri SellmeyerContributor: Sheri Sellmeyer
Topics: Exchanges, pharmacy benefits, copay coupons

The blogosphere has lately been abuzz with an important question for pharma: Can copay coupons be used for enrollees in the new health benefit exchanges that launched this month?

Read more.
Posted on: 10/10/2013 10:00:24 AM

Bill MelvilleContributor: Bill Melville
Topics: ACA, Exchanges

When searching for Week 1 winners in the Great Health Exchange Rollout, it’s probably best to avoid You can’t log onto the site anyway. If you live in Louisiana, you probably haven’t tried (seven enrollees as of Oct. 7).

Read more.
Posted on: 10/9/2013 11:35:15 AM

Merk CherryContributor: Mark Cherry
Topics: ACA, Exchanges, Obamacare

If you are still having trouble getting into the online health insurance marketplace, or your governor has essentially outlawed healthcare navigators, you may want to check out your local supermarket or strip mall. With health insurance now a required commodity, health plans are looking for new ways to engage potential customers, and that includes going into the traditional retail space.
Read more.
Posted on: 10/4/2013 2:31:56 PM

Sheri SellmeyerContributor: Sheri Sellmeyer
Topics: Exchanges, ACA

Today the new healthcare exchanges officially launched, but if I had wanted to sign up for an insurance plan in Georgia, Michigan, California, or Rhode Island, I would have been out of luck – at least as of 11:30 Central Time.
Read more.
Posted on: 10/1/2013 2:15:08 PM

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