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How blockchain technology will disrupt the PBM-payer-pharmacy relationship
pharmaceutical industry has many stakeholders. The primary purpose of the PBM is to serve as an intermediary ... the focus of this paper is on the private health care space. THE ORIGIN OF PBMS PBMs as we know them ...- Authors: Brian Anderson, Michael DiPrima , Greg Callahan
- Date: Apr 2020
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Technology & Applications; Technology & Applications>Blockchain & cryptocurrency
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Changing With the Times: The Past and the Future of ACA Risk Adjustment
drying on the Patient Protection and Affordable Care Act (ACA) legislation nearly a decade ago, issuers ... year.³ We then split each risk score into its primary components. Figure 1 shows two prominent patterns: ...- Authors: Jason Karcher , Cameron Kevin Gleed, Jason James Petroske
- Date: Jun 2020
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration; Technical Skills & Analytical Problem Solving
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Affordable Care Act (ACA)
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Biosimilars, Part 3: Humira Biosimilar Launches
patients everywhere. prescription drug costs, health care payment reforms, medical expenses By Gregory Warren ... inclusion in formularies so patients can have the care access they need. To remove Humira from your formulary ...- Authors: Tony Pistilli, Greg Warren
- Date: Nov 2023
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health insurance; Public Policy; Public Policy; Public Policy
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Biosimilars, Part 4: The Financial Impact
Biosimilars, Part 4: The Financial Impact Savings from biosimilars have accelerated significantly ... year’s big event. prescription drug costs, health care payment reforms, medical expenses By Gregory Warren ...- Authors: Greg Warren, Tony Pistilli
- Date: Nov 2023
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health insurance; Public Policy; Public Policy; Public Policy
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Claims Reserve Margin in the Health Annual Statement: A Review of 2016–2021
Claims Reserve Margin in the Health Annual Statement: A Review of 2016–2021 In preparing ... patterns may vary by region or size of the managed care organization. Additionally, certain states may have ...- Authors: Robert Lang, Elliot McLeRoy
- Date: Nov 2023
- Competency: Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Financial Reporting & Accounting; Financial Reporting & Accounting>Statutory accounting; Health & Disability; Health & Disability>Claims - Health & Disability
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Enhancing the Value of Critical Illness Insurance
Enhancing the Value of Critical Illness Insurance Critical illness insurance is a popular supplemental ... or Depressive Disorder and Use of Mental Health Care Among Adults During the COVID-19 Pandemic—United ...- Authors: Ashlee Borcan
- Date: Feb 2022
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Strategic Insight and Integration
- Publication Name: Product Matters!
- Topics: Health & Disability; Health & Disability>Critical illness insurance
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October 2019 issue of Health Watch
18|11: What Can We Do About the Cost of Health Care? We embarked on this nearly two years ago with ... to insert health care actuaries into the discussion on the rising cost of health care. This is not a short-term ...- Authors: Society of Actuaries
- Date: Oct 2019
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability
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Selling Insurance Six Feet Apart Redux
Selling Insurance Six Feet Apart Redux As part of the SOA’s July 22, 2020, COVID-19 Virtual ... passage from its August 20, 2020, RADAR on Medi- care Advantage newsletter and the article titled “E-Brokers ...- Authors: Nickolas Ortner
- Date: Oct 2020
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: News Direct
- Topics: Health & Disability; Life Insurance>Marketing and distribution - Life Insurance
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Traveling Actuary: The Edge of Reason
measure to mitigate too many people needing hospital care at the same time. Measures such as placing hard ... extreme stress test to emergency response and health care systems around the world. I hope we come out better ...- Authors: Society of Actuaries
- Date: May 2020
- Competency: External Forces & Industry Knowledge; Strategic Insight and Integration
- Publication Name: Reinsurance News
- Topics: Health & Disability