What are copay accumulators?
KFF reports on the increased use of copay accumulators: Oscar Health is one of many…
What are copay accumulators?
KFF reports on the increased use of copay accumulators: Oscar Health is one of many commercial health insurers that use what are often called copay accumulator programs to keep funds that are meant to defray patients’ out-of-pocket costs for expensive specialty drugs. Over the past decade, more insurers have adopted such strategies to reduce their prescription…
Ascension to Buy Tennessee Health System for Nearly $1B
Ascension is set to acquire Williamson Health, a county-owned health system in Tennessee, in a deal worth nearly $1 billion. Ascension’s offer beat out bids from HCA Healthcare and Optum. The post Ascension to Buy Tennessee Health System for Nearly $1B appeared first on MedCity News.
Elevance Sues CMS Over Star Ratings, Seeks Same Recalculation Applied to Clover
Elevance filed a lawsuit last week against the Department of Health and Human Services and the Centers for Medicare & Medicaid Services, alleging that CMS unlawfully refused to recalculate Elevance’s 2026 Medicare Advantage Star Ratings on the same basis that it recently recalculated Clover Health’s ratings after a court ruling. The post Elevance Sues CMS…
Vertex Pharma’s Growth Strategy Leads to Its Biggest-Ever M&A Deal
Vertex Pharmaceuticals’ acquisition of Crinetics Pharmaceuticals values the company at about $10 billion. Crinetics’s Palsonify could become a new standard of care therapy for acromegaly and the biotech also brings other drugs in various stages of development for endocrine disorders, a new therapeutic area for Vertex. The post Vertex Pharma’s Growth Strategy Leads to Its…
Digital Health Tools and Technologies: An Overview of CMS’ Recent Efforts to Expand Their Use in Medicare
As an increasing share of older adults have adopted digital health technologies over the past several years, and with most expressing interest in using them to manage their health care, the Centers for Medicare & Medicaid Services (CMS) has introduced several initiatives to expand the use of digital health technologies in Medicare. This brief summarizes…
The AI Use Case That Healthcare is Overlooking
AI performs best where a problem is well-defined, data-intensive, repetitive and operates at a scale that exceeds human tracking capacity. The supply chain hits all four. The post The AI Use Case That Healthcare is Overlooking appeared first on MedCity News.
The Foundation Is Built — Now We Must Secure the Future of Interoperability
Patients, providers, and innovators all benefit from secure, trusted, nationwide data exchange. But this trust cannot sustain itself on fragmented governance or competitive enforcement dynamics. The post The Foundation Is Built — Now We Must Secure the Future of Interoperability appeared first on MedCity News.
The Truth About Testosterone in Women: What Medicine Has Overlooked
Testosterone is not just a “male hormone.” Women need it too. And pretending otherwise has left countless women struggling through midlife while being told everything looks “normal.” The post The Truth About Testosterone in Women: What Medicine Has Overlooked appeared first on MedCity News.
Copay Assistance Is Meant To Defray Patient Drug Costs. Some Insurers Keep It Instead.
For 16 years, Larry Gruber, a fitness coach from Wilton Manors, Florida, received a coupon card to help him pay for a psoriatic arthritis medication he needs that costs more than $7,700 a month. Each year, Amgen, which makes the drug, called Enbrel, sent the coupon card worth thousands of dollars, and that counted toward…
Thousands of Medicare Beneficiaries Thought Their Drug Plan Was Free. Then They Lost It.
Jude Pare and his partner, Diane Tix, live in rural Minnesota until temperatures dip below freezing, when they take refuge in Arizona for the winter. While away, their mail is forwarded. But Pare, 77, said he didn’t receive any warning from his Medicare prescription drug plan that his $0 monthly premium was about to increase….
