Reimbursement

Luis Torres, MBA, Vice President, Managed Care, BioPlus Specialty Pharmacy, talks about popular strategies employers use to control drug spending.

Matthew Hughes, director of Business Development for the Accreditation Commission for Health Care (ACHC), discusses HIV and oncology distinction programs and how these standards bring patients, physicians, and pharmacists together to align care.

In entering into an arrangement with a physician in a rural area, the pharmacy needs to focus on the Stark rural provider exception.

John Giannouris, vice president, Specialty Pharmacy Services, ValueCentric, discusses how data aggregators work with pharmacies and manufacturers to boost patient support services.

Top news of the day from across the health care landscape.

Artificial intelligence could take over medication dispensing in the next 50 years.

Half of all HAE drug expenses were billed through the pharmacy benefit and half through the medical benefit.

The new method indexes thousands of cells simultaneously and could potentially improve understanding of various diseases at a molecular level.

The findings suggest that a patient’s diet may impact their ability to combat head and neck cancer.

In the largest study of its kind, breast cancer survivors were not found to have a greater mortality risk due to heart disease than the general population.

Unintentional weight loss may allow physicians to detect cancer sooner.

A look at last week's top stories in the world of pharmacy.

A look at last week's top stories in the world of pharmacy.

Pharmacy benefit manager reports specialty drugs drive 97% of spending for hereditary angioedema care.

Managed care organizations and pharmacy benefit managers are increasingly using strict approaches to manage drugs, including formulary exclusions.

A review found an elevated risk of cancer progression with increasing wait time between positive screening and start of diagnostic testing.

Last year, 41% of pharmacy drug spending was for specialty drugs compared with 59% for traditional drugs.

Nivolumab showed major tumor responses in early stage lung cancer patients and an increase in anti-tumor T-cells that remained after the tumor was removed.

Top news of the day from across the health care landscape.

New treatments for cystic fibrosis, migraines, and multiple sclerosis expected to help push specialty drug costs on the pharmacy benefit to nearly 50% of total drug spending by 2020.

Annual meeting explores how to overcome the challenges with patient care that community oncology practices face on a daily basis.

If pharmacies can avoid the problems implicated in the whistleblower case, then the risk of finding themselves in the government’s crosshairs will be substantially reduced.

CMS tweaked an opioid policy aimed at Medicare Part D patients that drew criticism when it was first released in draft form.

Services such as Uber and Lyft that help get patients to their medical appointments could also bring patients to their pharmacies.

Top news of the day from across the health care landscape.

Alcohol-dependent patients with hepatitis C virus comorbidity found to have greater deficits in the frontal, precentral, superior, and orbital volumes.

Hospital Readmissions Reduction Program established through the Affordable Care Act found to penalize facilities that serve a large number of minority patients.

Christopher W. Kennedy, MSM, Chief Operating Officer, Heritage Biologics, discusses how specialty pharmacies can implement value-based reimbursement.

Besides tracking the Healthy Days metric, Humana has focused interventions around social determinants of health: food insecurity, loneliness, and social isolation.