Co-Pay Cards & the Stalling of Drug Rebate Growth Part II – The HIE ‘Test Case’

Summary and Investment Conclusion On net, drug manufacturers are using co-pay cards to reduce the higher out-of-pocket (OOP) costs faced by beneficiaries on the health insurance exchanges (HIEs) as compared…

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ACA Enrollment Round-Up – How Many Have Paid Premiums; How Many Were Already Insured Last Year; How Their Health Compares to Employer-Sponsored Beneficiaries’

7.5 million persons selecting a plan … On Thursday the Administration announced a revised enrollment estimate of 7.5 million persons for the Affordable Care Act’s (ACA) health insurance exchanges (HIEs).…

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Index of Generic Drug Acquisition Costs Now Available to Pharmacies Nationwide; Commercial Plan Sponsors Likely to Shift Away from AWP

Summary and Investment Conclusions First DataBank and Medi-Span are the dominant providers of point-of-sale pricing information to US pharmacies. In December First DataBank announced it would provide National Average Drug…

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Harvest Time for the Bill Collectors? The ACA’s Narrow Hospital Networks May Spur Demand for Revenue Cycle Management (RCM) Services

Research Method and Key Findings We compared hospital networks for health plans sold on the Affordable Care Act’s (ACA’s) health insurance exchanges (HIEs) with hospital networks for comparable[1] plans sold…

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Your (HIE-based) Plan Doesn’t Cover That: A Comparison of Drug Formularies On and Off the Health Insurance Exchanges

Summary and Conclusions The prescription drug formularies of health plans sold on the Affordable Care Act’s (ACA’s) public health insurance exchanges (HIEs) are significantly more restrictive than the drug formularies…

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