Early next year, the Centers for Medicare and Medicaid Services (CMS) will remove the application of retroactive DIR fees and move DIR fees to the point of sale instead. The major issues with the DIR fees, which are paid by pharmacies to pharmacy benefit managers, are the fact that they drive up the costs of prescriptions for patients and delay reimbursement of care to the pharmacies. Now, a brand new issue will arise in early 2024 - namely, pharmacies will be facing a DIR “cliff” where
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Pharmacy | Medication Adherence Technology Services and Solutions | News, Analysis, Insights - HIT Consultant
High Drug Costs Threatening Affordability of Employer-Sponsored Healthcare
Large employers report that the biggest threat to self-funding medical coverage is the increasingly high cost of pharmacy claims. In their annual Health Benefits Priorities survey, MBGH found that employers consider pharmacy costs extremely problematic. Ninety-one percent of employers cited million-dollar treatments approved by the FDA, and 89% pointed to specialty drug spending as a top threat. Source: PSG 2023 Trends in Specialty Drug Benefits Report Employers already pay
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Report: Inaccurate Drug Discount Requests Reach Nearly $1B
What You Should Know: Kalderos, a data infrastructure and analytics company, identified nearly $1B in inaccurate drug discount requests from 2016-Q1 2023 on its drug discount management platform.The report, titled "Mission Critical: Bringing drug discount stakeholders together so patients win," outlines Kalderos' vision for a new paradigm of cooperation among drug discount program stakeholders in which everyone benefits — particularly patients. Rising Costs of Inaccurate Drug
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How Healthcare Providers Can Bolster Cybersecurity Defenses and Protect Patient Data
In IBM’s 2022 Cost of a Data Breach report, the company revealed that the global average cost of a data breach was $4.35 million. In the healthcare sector, however, that number skyrocketed to $10.1 million. Why is an attack on a healthcare organization so much more costly? While part of this comes down to the fact that healthcare organizations often have big budgets, and so might be able to pay big ransoms, the biggest part of the answer is consequences. In there, real lives are at stake. Downed
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AmerisourceBergen Launches Pharmacy Telehealth Pilot with SteadyMD
What You Should Know: AmerisourceBergen (AB), a global healthcare company, has announced a strategic partnership with SteadyMD, a B2B telehealth infrastructure provider for the co-creation of a telehealth solution focused on Test to Treat opportunities. The solution is being offered as a pilot to independent community pharmacies across the US.In addition to the commercial partnership, AmerisourceBergen has also made a minority investment in SteadyMD through its venture fund AB Health
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The Importance of Decoding Health Data to Every Organization
To the observant onlooker, data is everywhere. From spending habits to hospital visits, humans are walking treasure troves of information. As technology has exponentially improved in the last 20 years, so has the collection of data. In 2010, a mere two zettabytes of data were created, captured, copied, or consumed. In 2020, estimates put that number at 79 zettabytes. Data collection goes hand-in-hand with the revolution of the Information Age — since the 1970s, unprecedented digital
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M&A: Kaiser Acquires Geisinger, Forms Risant Health
What You Should Know: Kaiser Foundation Hospitals and Geisinger Health are teaming up to launch Risant Health and a definitive agreement to make Geisinger the first health system to join Risant Health to expand access to value-based care in more communities across the country. Upon regulatory approval, Geisinger becomes part of the new organization through acquisition.Risant Health is a new nonprofit organization, created by Kaiser Foundation Hospitals, to expand and accelerate
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Uber Health Embeds Same-Day Prescription Delivery Into Its Care Platform
What You Should Know: Uber Health, Uber’s healthcare arm, today announced same-day prescription delivery on its HIPAA-supported, centralized platform.For the first time, those using Uber Health—including healthcare providers and health plans—will be able to manage prescription delivery from any pharmacy in their service area through the same platform they already use to coordinate transportation for patients. This launch enables providers to offer a full suite of care solutions that
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Flume Health Launches Tool to Remedy Health Insurers’ Fatigue
What You Should Know: - Flume Health, a healthcare technology company for payer operations launches Flume Relay to systematize the complex solution integration process involved in designing, launching, and administering a health plan. - Flume Relay aims to solve payers’ greatest limitation: the integrations and real-time data exchange with the plethora of vendors and systems that make up a health plan. Health Plan Vendor Fatigue Health plans are experiencing vendor fatigue at an
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KLAS: 340B 2023 – Functionality & Pricing Drive Purchase Decisions
What You Should Know: - Purchasing energy in the 340B market has been high in recent years as (1) healthcare organizations have sought to increase savings, particularly in cost centers like pharmacies, and (2) 340B vendors have expanded the types of customers they serve, according to a recent KLAS report. - This new report examines 49 recent purchase decisions validated by KLAS between October 2020 and October 2022 to understand why certain vendors are seeing the most purchase energy and
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