Health Plan Management

Why You Might Want to “Fear the Steer”

Who Would Steer You to Fill Prescriptions at Their Own Specialty Pharmacies? They Decide Your Destination We have shared multiple examples of the cost to a “captive healthcare audience”, especially in hospitals and there is a variation occurring that can impact your co-pays and overall medication spending. This growing trend happens when hospitals and health systems are …

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When No Surprises are a Good Surprise

One of the best “surprises” of 2022, which affects anyone paying bills for healthcare, is the “No Surprises” Act.1 It went into effect at the start of the year.  What the act is intended to do is indicated in its name.  Officially, it is part of the Consolidated Appropriations Act of 2021, its purpose is to eliminate a …

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PBM Warnings & Ramifications

Our blogs have previously addressed how traditional Pharmacy Benefits Managers (PBMs) can increase the price of prescribed medications. PBMs are essentially companies that manage prescription drug benefits, “acting as the go-between for drug manufacturers and employers. However, PBMs do not always do so with the intention of securing the most cost-effective drugs, affecting access to …

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