Market Insights

Insurers and employers are expected to be reluctant or even unable to immediately begin charging copays or deductibles for the affected preventive care for certain services, such as screening for diabetes, hepatitis and certain cancers.

The likelihood of consumers purchasing insurance for valuables, pets and households varies based on age, education and location.

Employers, brokers and TPAs need to calibrate their expectations for how Humira biosimilars will impact the cost of prescription drugs for groups and members.

Many insurers are offering smaller networks of doctors and hospitals, and problems arise when patients cannot find local in-network providers and must pay more for out-of-network care or travel farther for in-network care.

About half of all patients are getting hit with facility fees, which are billed for doctor visits at hospital-owned clinics, as three in four physicians are now employed by hospitals, health systems or other corporate entities.

The limits stem from an opioid settlement with AmerisourceBergen, Cardinal Health and McKesson that flag and sometimes block controlled substances – and patients with anxiety and sleep disorder are caught in the crosshairs.