Medicare & Medicaid
Medicaid expansion has resulted in more people having health insurance among all potentially eligible individuals, regardless of race, age, marital status or income.
Even after taking into account manufacturer rebates, spending still increased more than 60 percent and the ranks of beneficiaries paying $2,000 out-of-pocket a year doubled, the Office of the Inspector General says.
The deal boosts company's government-sponsored, managed care Medicaid and Medicare Advantage, Part D businesses and enhances its pharmacy benefit manager platform.
States with at least 85% of their Medicaid population in managed care could implement nominal payment cuts without ensuring providers will assure access to care.
Plans may be losing out on millions in missing the 20- to 40-percent of buyers who are not ready to sign up for Medicare at age 65.
Those results add to evidence showing support for social service programs can improve community health outcomes and reduce healthcare spending.
As the 2019 transition approaches, finding expertise to support changing payment models will become more difficult, and likely expensive.
Specialists say legislation is needed to grow workforce and hold pharmacy benefit managers accountable for driving prices up for consumers.
CMS existing policy requires plan sponsors to ensure enrollees pay the lesser of the Part D negotiated price or copay.
More than 44 million American adults have a diagnosable mental health condition, and rates of severe depression are worsening among young people.