Consumer Driven Health Care

According to a HHS audit, medical records provided by the health insurer didn't support certain diagnosis codes, similarly to Cigna's lawsuit culminating in the insurer's agreement last week to pay $172 million to resolve allegations.

Pharmacists at Walgreens in four states staged a walkout on Monday, citing increasing staffing shortages and job duties, just weeks after CVS pharmacists walked off the job because of similar working conditions.

Forecasters are dealing with a unique set of factors this year, including the post-pandemic winding down of care avoidance, the emergence of new drugs and the expiration of 2-year contracts with providers, says a new report.

Deloitte analysis indicates genders consume health care differently, with women seeking more care and treatment.

Using Blue Shield of California as a precedent, more health entities may scale back their reliance on their PBMs in favor of centers of excellence that provide specific services. But this new approach to pharmacy benefits needs an organized and connected way for information to be shared.

The pharmacy benefit manager is accused of pressuring Iowa-based Osterhaus Pharmacy into paying "direct and indirect remuneration" for filling Medicare prescriptions.