Posts tagged ‘benefit design’

Reference Pricing — Coming soon to a health plan near you?


There is great interest in reference pricing in the US for select medical procedures and branded drugs. While only 10% of mid-sized and large employers are utilizing reference pricing, more than 2/3 of employers have an interest in this payment technique. If it takes hold, there is a potential impact on utilization, revenue and quality of care that manufacturers will need to address.

Continue Reading November 11, 2015 at 6:00 PM Leave a comment

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

Gene therapy — The price is right?


The introduction of the first gene therapy presents challenges for payers. These costly therapies will require new approaches in terms of pricing benchmarks and reimbursement methodologies.

Continue Reading October 2, 2015 at 4:32 PM 1 comment

MedSpan Research Pay-For-Performance Case Study


MedSpan Research Pay-For-Performance Case Study http://wp.me/pReqv-m:

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 Managed Markets Perspectives


MedSpan Research’s Managed Markets Perspectives: Pay For Performance Programs are becoming more prevalent. Dialysis facilities are already using this type of reimbursement program to improve on quality measures.

Continue Reading July 21, 2015 at 11:21 AM 1 comment

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