PhRMA’s Post

U.S. Healthcare System is Broken - 93% of Americans say their healthcare is not worth what it costs https://lnkd.in/gTvw_yNm  - Too many people take too many pills: Medical systems are set up to put people on drugs, not take them off - The Innovation #HealthCare Really Needs is Help People Manage Their Own Health - Prevention-as-a-Service and wellness to live healthier, happier life for sure beats sickcare - AI augments clinician decisions to improve speed & quality and primary care moving from MD's to PA's and NP's as discussed in my recent webinar on Augmentedintelligence will become futureofwork in Healthcare https://lnkd.in/gjZrpCcW now > 4600 impressions Cheers.....Steve AI startup advisor 'force multiplier' https://lnkd.in/g38mWcs

How to redistribute healthcare dollars from the bedside to the boardroom 

Interesting article addressing a rising trend. Medical claims are becoming increasingly complex, leading to a significant impact on the affordability of healthcare. According to Axios, emergency room visits are particularly affected by this trend. The Peterson-KFF Health System Tracker's analysis highlights the toll that the complexity of claims is having on individuals' wallets. #healthcare #medicalclaims #affordability

#Costrelateddrugnonadherence #Patientsupport #Healthcarecosts #Globalsolutions Cost-related drug non-adherence (CRN) is an escalating concern in global healthcare. As is known , it occurs when patients skip or alter their medication regimen , knowingly or unknowingly .Some of the issues , impact and possible solutions are looked into here : Issues: • High Medication Costs • Inadequate Insurance • Low Income • Chronic Conditions • Complex Regimens • Lack of Awareness of Impact Impacts: • Poor Health Outcomes • Increased Hospitalizations • Higher Healthcare Costs Solutions: • Affordable Insurance • Generic Medications • Price Caps & Transparency • Medication Reviews • Patient Education & Assistance

The landscape of Medicare Part D prescription drug benefits is undergoing significant changes due to the Inflation Reduction Act (IRA), which increases the financial liability for health plans. Navina's latest update enhances support for RxHCC risk coding, helping to ensure that health plans can more accurately manage the complexities of the new financial landscape and maintain stability. For a detailed look at how these changes impact healthcare providers and plans, and how Navina can help, read our new blog post: https://lnkd.in/dqxCbXB6

👀Here's our take on today's much anticipated @HHSGov #IRA announcement.... Medicare may have "negotiated" a better deal for health insurers – but we don’t really know yet because the @CMSGov materials compare their prices to “list” prices versus actual market prices. Unfortunately, there's still no guarantee that Medicare beneficiaries are going to see meaningfully lower prices at the pharmacy counter. It remains a lost opportunity that CMS will not require Medicare Advantage plans to place government price set drugs on the lowest cost formulary coverage tiers. Requiring plans to charge $0 copays for government price set drugs is the most efficient way for CMS to help beneficiaries at the pharmacy counter. CMS allowing plans to keep charging beneficiaries up to 50% coinsurance while also creating a new demo to pay increased subsidies to health plans makes little practical sense for consumers. It also does not justify the negative, penalizing impact that the IRA already is having on new small molecule R&D for diseases of aging.

When PBMs fail to prioritize their members (your employees), they risk alienating them and creating barriers to engagement. Members who feel unheard or unvalued are less likely to trust their PBM and may be hesitant to participate in the drug assistance programs you provide. This lack of engagement can lead to poorer health outcomes, higher healthcare costs, and a strained relationship between the member and their PBM. As a Fiduciary PBM, we understand the critical role that member-centric care plays in driving engagement in assistance programs. By treating our members with the utmost respect and attentiveness, we can help with managing their prescription medications and create a positive impact on their lives. Join us in our mission to prioritize member needs and improve engagement! Together, we can make a difference in the lives of those we serve. Reach out to us on LinkedIn to learn more. #MemberFirstApproach #SpecialtyDrugAssistance #FiduciaryPBM #HealthcareEngagement

👵👴 Why is Medicare essential? 🏥 ✨ It's more than just a health plan – it's peace of mind! 🌟 Medicare ensures access to quality healthcare for our seniors, covering crucial services like hospital stays, preventive care, and prescription drugs. 💊 🏨 Don't gamble with your health – Medicare has your back! 🤝 Let's prioritize health and well-being together! 💙 Visit here for more information & questions: https://buff.ly/3pHNNp8 #MedicareMatters #HealthcareForAll #SeniorsDeserveTheBest"

We’ve been getting a lot of questions in our public sector practice about all the changes to in the Inflation Reduction Act and the impact on MAPD. Well… Big changes are coming to Medicare Part D (the prescription drug piece of Medicare) in 2025 that will impact employer group health plans, and we’re here to help break it down. Check out our on-demand webinar where HUB experts review changes to the Medicare Part D rules, and what these changes mean for employers, their employees and their compliance obligations. https://ow.ly/7eEr50TtVbc #EmployeeBenefits

Despite reforms in multiple states and at the federal level, physicians are still feeling the burden of prior authorizations, according to new research. Meanwhile, how Part D plans will treat the IRA's negotiated drugs will depend largely on the drug class each therapy is in. This and more in today's issue of Health Plan Weekly. Subscribe and save to any AIS Health publication this month with discount code SAVE10%. #InflationReductionAct #MedicarePartD #pipeline2patient Norstella https://hubs.ly/Q02Lykj00