Winning Strategies for MA Plans and PDPs Under the Mid-July Medicare Law; Health Plan Strategies for Using Predictive Modeling in Underwriting


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April 24, 2008


"Typically pharmacies make a higher markup on [over-ther-counter drugs] than they do on their prescriptions, so we had to account for" the concern of pharmacy providers about being reimbursed for OTC sales in the same manner as Rx products. "We came to a reasonable reimbursement rate for these over-the-counter products, that both the plan could live with and our retail pharmacies could live [with]."

— Mark Brueckl, assistant director of pharmacy affairs at the Academy of Managed Care Pharmacy, who helped implement an OTC incentive program when he worked at Independent Health In Buffalo, N.Y., a few years ago.

Today's Featured Story

Estranged Blue Cross and Blue Shield Plans Collaborate to Provide Hospital Quality Data

$71 million

…were the combined 2007 losses posted by Minnesota's eight nonprofit health insurers, according to the Minnesota Council of Health Plans.


Health Reform and the 2008 Elections:
What's Ahead for Health Care Access, Delivery and Financing

July 10-11, The Washington Court Hotel, Capitol Hill, Washington, D.C.
Speakers include Senators Rockefeller, Hatch and Wyden and Congressmen Stark, Waxman and Camp. You'll also hear reform perspectives from the Clinton, McCain and Obama presidential campaigns, leaders from prominent health business organizations, health policy analysts, and state legislators. Click here.

People On the Move
SSM St. Mary's Health Center in Richmond Heights, Mo., hired Sharon Dudley as executive vice president and chief operating officer. Dudley replaces Tim Wadman, has who held the position on an interim basis since October 2007. Dudley was regional chief nurse executive at Abrazo Health Care in Phoenix.…Poudre Valley Health System in Fort Collins, Colo., named William Neff chief medical officer. Neff is also the chair of the Poudre Valley Health System's board of directors. He has been an anesthesiologist in Fort Collins since 1990.

Medicare Part D: A Comprehensive Analysis of CMS Rules
This 217-page book includes chapters on sponsors, eligibility and enrollment, formularies, and CMS enforcement — and distills from thousands of pages of government regulations and guidance the major rules, guidelines and deadlines you need to comprehend this program. Click here.

Today's Featured Health Business Job Opening

CalOptima
Chief Financial Officer
Orange, Calif.


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Information contained in AIS's Health Business Daily is included with the understanding that Atlantic Information Services, Inc. is not engaged in rendering legal, accounting or other professional services. If legal advice or other expert assistance is required, the services of a competent professional person should be sought.


Sponsors
2009 Medicare Advantage Rates: Immediate Strategies for Health Plans
An audioconference
April 29, 2008

Register today.




2000-2007 Survey Results: Pharmacy Benefit Trends & Data
Featuring hundreds of charts, tables and graphs on costs, benefit design, utilization and PBM market share.
Click here


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