Consumer Driven Health Care

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.

In January, new federal rules will pose restrictions on how Medicare Advantage plans use algorithm tools that match patients with similar diagnoses and characteristics to make some coverage decisions.

As 2023 closes out, advisors and other benefits professionals are sorting through the implications of a recent maze of health reform measures as the U.S. system continues to struggle along.