Pharmacy
The Medicare population is estimated to have the highest and fastest growing prevalence of opioid use disorder in the U.S.
CVS Caremark, Walmart disagreed over reimbursement rates in the commercial and managed Medicaid pharmacy network.
Average total spend per hospital admission rose 18.5 percent between FYs 2015 and 2017, spawning roughly $1.8 million in new spending, study says.
Agency instead offers insurers a reduction in user fees for participating in the Affordable Care Act market.
Minor differences in co-payments sometimes mask exponential differences between similar generic formulations.
Providers get a reduced wait time in the prior authorization process, which is usually manual and paper-based.
The retailer is terminating its deal with its PBM, putting commercial and managed Medicaid beneficiaries out-of-network.
Including the original founding members, Civica Rx now represents nearly 750 participating hospitals, the company says.
Also, physicians are not incentivized to prescribe more expensive prescriptions, Community Oncology Alliance says.
The CoverMyMeds' RxBenefit Clarity solution leverages information from pharmacy network and payers on patient pay and benefits.