Feb 29, 2024

No prudent fiduciary would knowingly agree to pay 250 times more than the price available to anyone off the street — yet that’s the core allegation in the J&J lawsuit, where the company is accused of paying upwards of $10,000 for a drug available for cash for about $50. Rather than rehash the gory details of the...

Feb 22, 2024

Digital health vendors and virtual care point solutions only have a reason to exist if they perform better than traditional community providers — better outcomes, better affordability, better engagement. So how are they actually doing? Rik Renard from Awell, coauthor of a survey of 235 digital health professionals...

Feb 15, 2024

How Much EBCs and Brokers Really Make Off Plan Sponsors, With AJ Loiacono (Encore EP379)

Why the CAA Makes This a “Magical Moment” to Demand Broker Fee Disclosure. Encore Episode 379.

What if your broker or employee benefit consultant is collecting $40 per prescription in hidden compensation from your PBM — and...

Feb 8, 2024

Poor pharmacy benefit strategy has documented, unintended consequences: rising costs of care, bankruptcies, and declining member satisfaction — and that’s before considering the human cost when a plan denies access to a drug a patient genuinely needs. Nina Lathia, RPh, MSc, PhD, CEO of Healthcare Decision Making and...

Feb 1, 2024

About half the time, the cash price for a medical service is actually cheaper than the “negotiated” insurance rate — a fact that matters enormously given that roughly 90% of patients never meet their deductible in any given plan year. Marshall Allen, investigative journalist and founder of Allen Health Academy,...