Posts filed under ‘Insurance Design’

MedSpan Musings — Tips for better payer market research

2015 08 25 rodin the thinker for MedSpan MusingsMedSpan Musings — Tips for better payer market research  

The benefit covering a drug is not always obvious
When discussing benefit coverage of drugs with payers, remember that some health plans at first cover drugs under the medical benefit and then transfer those costs each month to the pharmacy benefit. Be sure to probe for this approach and its implications for drugs administered in physicians’ offices and alternate sites of care.

October 12, 2015 at 5:51 PM Leave a comment

MedSpan Research Pay-For-Performance Case Study

MedSpan Research Pay-For-Performance Case Study

Connectivity is one of the Key Underlying P4P Programs…Read more to learn why

Continue Reading July 21, 2015 at 2:00 PM Leave a comment

MedSpan Research’s Tips for Conducting Payer Research

MedSpan Research’s Mentions…Here’s a Tip!


MedSpan Research finds that many consumers do not know the type of Medicare (Fee for Service vs. Advantage) or Medicaid (state vs. managed) insurance they have. When conducting an Internet survey with consumers, ask them to look at their insurance card to give you an accurate answer.

June 23, 2015 at 9:02 AM Leave a comment

2015 Started Out With 89 New ACOs Joining the Medicare Shared Savings Program

89 new ACOs joined the Medicare Shared Savings Program starting January 2015, increasing the total participating ACOs to 424; including the Innovation Center’s 19 Pioneer ACOs. The 89 new Shared Services ACOs added 23,000 additional physicians and other providers to the Medicare Shared Savings Program’s provider network. The Share Services ACOs combined with the Innovation Center’s 19 Pioneer ACOs will serve over 7.8 million beneficiaries.

Continue Reading March 25, 2015 at 2:20 PM Leave a comment

Will Health Insurance Exchanges Make a Difference?

The majority of states’ insurance markets are led by one insurer. This is a reason why one of the goals of the health insurance exchange is to introduce new carriers to increase competition among insurers.

Continue Reading July 9, 2013 at 4:38 PM 1 comment

ACA to Greatly Benefit those with Pre-existing Conditions

Under the Affordable Care Act, those with pre-existing medical conditions cannot be denied health insurance, nor experience higher premiums just because of their conditions. This is likely to cause an increase in market size for healthcare device and therapy manufactures who target patients with pre-existing conditions.

Continue Reading July 2, 2013 at 10:07 AM 2 comments

Your Customers are Living in the Wrong State!

The number of health insurance plans to be offered in the new online health insurance exchange will widely vary from state to state. This can negatively impact drug and device manufacturers if their customers live in states that don’t offer a large number of plans. Read on to learn why.

Continue Reading June 20, 2013 at 9:53 AM 2 comments

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