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Managed Care April 2005	Medicare Modernization Act to Increase Public Sector Spending Nearly 50 Percent While the burden on the public sector to supply health care benefits to Medicare and Medicaid enrollees will increase, on the private side, a reevaluation of current forms of health insurance coverage may take place as growth in premiums continues to outpace growth in compensation.
Managed Care June 2003	HMO, Medicaid formularies exhibit surprisingly small differences When you compare HMO and Medicaid formularies for coverage in major therapeutic areas, you find that the differences are relatively small, with Medicaid plans being somewhat less stringent.
Managed Care November 2003	States exempt psychiatric drugs in some Medicaid programs While states are implementing broad policies to control Medicaid costs, outpatient prescription psychiatric drugs are falling into newly created exemptions, according to a recent survey conducted by the Bazelon Center for Mental Health Law.
Managed Care August 2002	24 States Hope Pharmacy Plus Helps Medicaid Twenty-four states may gamble that providing a prescription drug program to low-income elderly who do not qualify for Medicaid could save them money in the long run.
Managed Care November 2002 John Carroll	Drug Companies Crying Foul Over Medicaid's Formulary Push With states' preferred drug lists spreading like a prairie wildfire, the manufacturers have mounted a furious legislative counterattack, funding grass roots campaigns aimed at fanning the opposition in state legislatures even as they wage a legal war in state and federal courts.
Managed Care March 2008	PDP Drug Restrictions Block Comparison Shopping A review of 169 commonly used drugs covered by Medicare Prescription Drug Plans (PDPs) reveals that only 4 of the 10 largest plans by enrollment have all of those 169 drugs on formulary.
Managed Care January 2007	Seventy-Five Percent of Cancer Drugs Covered Under Medicare Part D Seventy-five percent of cancer drugs are covered by Medicare Part D plans, with regional Medicare Advantage prescription drug plans covering 85 percent.
Managed Care December 2005 Martin Sipkoff	Reports Confirm High Value of Step-Therapy Programs Tiered benefit design and mail order pharmacy are useful, but don't overlook this other significant vehicle for savings: step therapy programs.
Managed Care August 2002 Madeleine A. Estabrook	Regulators Take More Interest In Role of PBMs in Health Care In a highly regulated industry such as health care, it is just a matter of time before every component of the industry comes under scrutiny and review. Pharmacy benefit managers are taking center stage now.
Managed Care September 2004 John Carroll	Pfizer: DM Did Not Fizzle In Florida Medicaid Ruckus Medicaid officials close the books on a program the pharmaceutical giant contends that soon-to-be-released data will verify its disease management program's effectiveness.
InternetNews October 13, 2004 Roy Mark	Report: The Internet and Drugs Don't Mix It seems an increasing number of Americans are researching drugs online, but safety fears chill buying.
The Motley Fool February 25, 2010 Brian Orelli	An Untouched Market Waiting to Be Captured Unfilled prescriptions are a potential boon to drug companies.
Managed Care March 2001	Maine Gets HCFA Waiver for Drug Discount Program The Health Care Financing Administration has given Maine officials clearance to offer a discount prescription program to 200,000 people without a pharmacy benefit...
Managed Care February 2006	Managed Care Offered to More Medicaid Enrollees A chart illustrates the percentage of medicaid enrollees in managed care, for the years 1996 to 2004.
Managed Care February 2007	Managed Care Outlook Coverage for children leads policy debate.
Managed Care March 2006	Prescription Drug Cost Increase Lowest Since 1994 A slowdown on spending for prescription drugs is credited for leading the slowing in health care costs overall, according to a recent study.
Managed Care August 2000	With Cost Study, Group Argues For OTC Benefit A study by HECON Associates, a Maryland-based market research group, supports the claim that when prescription drugs become available over the counter, consumers face increased out-of-pocket costs.
Managed Care January 2008	Copayment Rates Outpace Inflation Workers are definitely paying more for health benefits today than they were in 2000, especially for prescription drug copayments.
Managed Care July 2006	Public Payers Foot Greater Pharmacy Costs Through 2005, private health insurance had covered most of the cost of prescription drugs. That picture is changing as public payments, mostly under Part D, are projected to exceed private health insurance and out-of-pocket payments.
Managed Care October 2004 Arthur Lazarus	Formulary Restrictions Sometimes Harm Patients Much more research is needed to determine the full effect of drug benefit designs. Quality must be the foremost concern.
The Motley Fool December 6, 2004 Brian Gorman	Pill-Popping Nation Americans are using more prescription drugs. Unfortunately for big pharma investors, pharmaceutical companies' benefits from these trends are tempered by other factors.
Managed Care August 2000 Carey Lee Straetz	Managing Medicaid Rolls Often State-by-State Affair Despite the strong economy, Medicaid enrollment may be slowly rising after a three-year decline. The challenges for serving this population are huge.
Pharmaceutical Executive July 1, 2005 Patrick Clinton	Playing Doctor Why Congress plans to ban erectile dysfunction drugs from Medicare and Medicaid, and why they shouldn't do it.
Managed Care March 2008	Drug Caps Lower Spending, but .... These policies tend to make consumers shoulder some of the cost of prescriptions and the cost could be a barrier to medication adherence.
Managed Care April 2005 John Carroll	Can Managed Care Programs Rein in Medicaid's Runaway Budgets? Cadillac or Yugo care for the poor? Fee-for-service or managed care? The states have a lot on their minds as the Medicaid monster grows and grows.
Managed Care December 2004	Number of Prescriptions Grows Faster Than Population With the rising costs of prescriptions and other issues relating to implementation of the new Medicare drug benefit, it is no wonder that policymakers are considering new approaches to addressing drug costs.
Registered Rep. September 18, 2013 Kevin McKinley	Having Money and Getting Medicaid Clients who want to have both their money and Medicaid may want to purchase a specific type of long-term care insurance known as a "partnership" policy, currently available to residents in 31 states.
Managed Care October 2005 Martin Sipkoff	Restrictive Formularies May Be Contagious It's the law of unintended consequences: A restrictive drug formulary maintained by a health plan may influence how physicians treat patients unaffiliated with that plan. What does this mean to managed care?
Managed Care March 2006	Health Costs Expected To Hit $4 Trillion in 2015 The amount the U.S. spends on health care will reach $4 trillion, or about 20 percent of gross domestic product in 2015, according to a report by the National Health Statistics Group, a division of the Centers for Medicare & Medicaid Services.
Managed Care February 2005	Medicare's Drug Coverage Seeks To Strike Compromise Health plan officials are still trying to determine just how the final rules for the new Medicare prescription drug benefit will affect them, because it appears that government officials tried their best to address the competing concerns of all players.
Managed Care February 2002	Hospital costs lead way in health care expenditures The share of the gross domestic product attributed to health care increased slightly more than overall GDP growth from 1999 to 2000 -- the first time that's happened in nine years...
Managed Care July 2002	Despite Deficits, States Avoid Cutting Medicaid, CHIP Rolls Although states are straining to close budget deficits, they have refrained from introducing stringent eligibility requirements for the CHIP and Medicaid programs.
Managed Care January 2001 John Carroll	Florida Leads the Way in Attempting Disease Management for Medicaid Officials across the country are watching to see whether the Sunshine State's innovation can save money...
Managed Care February 2007 Martin Sipkoff	As Drug Payment Model Changes, Confusion Grows Among Insurers Purchasers are hopeful that life after "average wholesale price" will be simpler, fairer, and, with luck, easier to grasp.
Managed Care July 2004 Martin Sipkoff	Managed Medicaid Business Might Be Worth the Difficulties Financial, regulatory, and access problems continue. Still, this remains a growth industry and some have found a way to profit.
The Motley Fool August 18, 2006 Dan Caplinger	The Medicare Drug Dilemma: Part 1 Seniors have a great benefit available to them, but it's tough sorting through it all. We're here to help.
BusinessWeek February 21, 2005	Mooching Off Medicaid The state-run medical-care programs originally designed to help poor mothers and their children now increasingly pay for nursing-home care for seniors. While many of those seniors are genuinely poor, others are not. The rules should be tightened.
CIO September 26, 2013 Stephanie Overby	Big Data Project Cuts Prescription Costs Express Scripts analytics portal helps doctors prescribe more cost-effective medicines.
Managed Care March 2007	Use of Generics On the Rise Recent data indicate that generic medication accounts for nearly 60% of the drugs dispensed to people in Medicare Prescription Drug Plans and Medicare Advantage plans.
Managed Care January 2006 Martin Sipkoff	Old Techniques Never Die, Nor Even Fade Away Urged on by employers traumatized by costs, health plans are renewing their interest in prior authorization, but using a lighter hand.
Reason April 2001 Ronald Bailey	Goddamn the Pusher Man Why does everybody seem to hate the pharmaceutical industry?
Pharmaceutical Executive February 1, 2014 Jill Wechsler	Drug Coverage, Costs Under Scrutiny Benefits offered by insurance plans on health exchanges and through Medicare are raising concerns about patient access to needed therapies
Managed Care December 2005	Pharmacy Cost Increases Below Medical for the First Time in Four Years According to a survey of 70 health care insurers, prescription costs are expected to increase at a lower rate than medical costs during the next 12 months.
The Motley Fool July 30, 2010 Brian Orelli	A Faster Pathway to Drug Approvals A thinktank called the Pacific Research Institute has proposed letting drugs approved by the European Medicines Authority onto the market in the U.S. before the Food and Drug Administration has approved the drugs.
Managed Care October 2001 Bob Carlson	Trying To Get Control of Drug Costs, Florida Earns Kudos -- and a Lawsuit Pharmaceutical Research and Manufacturers of America (PhRMA) filed suit against Florida's Agency for Health Care Administration, challenging a new Medicaid formulary that requires manufacturers to pay supplemental rebates to have their drugs included...
The Motley Fool October 5, 2010 Andrew Bond	Wal-Mart Enters the Health-Care Fray Wal-Mart and Humana's partnership will have competitors scrambling.
Financial Planning September 1, 2008 Donald Jay Korn	Pleading Poverty Few things can play havoc with a thoughtful financial plan as surely as a long stay in a nursing home. Therefore, "Medicaid planning" has become a prime concern for many seniors and their younger relatives.
Managed Care March 2001	Does Cost-Sharing For Drugs Lead To Adverse Events? A study in the Journal of the American Medical Association suggests that HMOs' increased use of cost-sharing to soften prescription drug expenses may have actually increase overall medical costs over the long term.
Reason February 2009 Ronald Bailey	I Want a New Drug States that adopted new drugs more rapidly, had the smallest increases in disability rates.
Managed Care October 2004 Tony Schueth	Formulary Standards Key To E-Prescribing Success Electronic prescribing needs standardization before it's adopted by the masses. Start with the format of formulary databases.