Cost-Containment

Evaluating and designing a benefits package that packs a punch is a big lift that requires the involvement of an organization's top decision makers, who may want to assess employees' needs, preferences and expectations.<br>.

The lawsuit, which alleges that the pharmacy benefit manager colluded with Prime Therapeutics to charge higher fees, comes weeks after an independent pharmacy association launched an investigation into PBM fees.

When employers were asked about strategies for managing costs for 2024, utilization control initiatives, such as prior authorization, case management, disease management and nurse advice lines took center stage, says a new report.

When doctors encourage informed referrals to specialists who can demonstrate lower costs and better outcomes, this can have a significant impact on VBC program costs, sometimes resulting in millions of dollars of annual savings.

Those 65 and older joining Medicare for the first time can buy a supplemental, or "Medigap," policy, which covers many out-of-pocket costs, such as deductibles and copays, which can be substantial.

Hospitals are marking up the prices for biologic medicines more than physician offices, particularly for "innovator biologics" that have clinically equivalent (and lower cost alternatives) on the market, says a new report.