Pharmacy Benefit Management

With elective procedures delayed, UnitedHealth profit spikes | 7/15/2020

… analyst expectations for $63.48 billion. UnitedHealth runs UnitedHealthcare, a health insurance business that covers about 48 million people, mostly in the United States. The company’s Optum segment also runs one of the nation’s largest pharmacy benefit management operations as well as a growing number of clinics and urgent care and surgery centers. Surgical procedures and other medical visits are expected to ramp up in the year’s second half if COVID …

Payers Can Use Telehealth to Increase Convenience for Members | HealthPayer Intelligence | 7/15/2020

… having 1,500 HealthHUBS open by 2021, providing preventive care, primary care services, and chronic disease management support. CVS Health announced the launch of first of these sites in 2019 along with CVS Health’s new pharmacy benefit management service. Beyond physical locations, however, convenience attracted consumers and providers alike to digital health and telehealth solutions. Nearly half of the consumer respondents (48 percent) said that they were more likely to connect …

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ENVISIONRX ONCE AGAIN RECOGNIZED FOR ITS COMMITMENT TO QUALITY BY URAC | Globe Newswire | 7/14/2020

… 2020 (GLOBE NEWSWIRE) – EnvisionRx , a pharmacy benefit manager (PBM) and division of EnvisionRxOptions, a wholly owned subsidiary of Rite Aid (NYSE: RAD), today announced it has received renewal of the Drug Therapy Management and Pharmacy Benefit Management accreditations from URAC, both of which the company has held since 2007. URAC is a non-profit organization with a mission to advance quality in healthcare through leadership, accreditation, measurement and innovation. The …

Friday Health Plans Partners with Capital Rx for Pharmacy Benefit Administration | Business Wire | 7/14/2020

… company’s commitment to innovation, technology, and service is why Capital Rx is the fastest-growing pharmacy benefit manager in America. For more information, please visit http://www.cap-rx.com . About JUDI JUDI is Capital Rx’s pharmacy benefit management platform, a cloud-native solution offering truly plug-and-play integration with hundreds of data sources and vendors. JUDI’s technology allows for seamless communication with all stakeholders in the form of advanced analytics …

Self-Insured Employers, Plan Sponsors Discover Value of Specialty PBM & Medical Infusion Carve-Outs: Largest TPAs, SIIA Regulatory Expert Present Episode 2, AscellaHealth Educational Webinars | Business & Finance | manchestertimes.com | Business Wire | 7/14/2020

… Institute of America (SIIA) . Episode 2 of the 2020 Webinar Series “From Evolution to Revolution: How the Rise of Specialty Pharmacy Drove a New PBM Model” focuses upon cost-curbing solutions related to specialty pharmacy benefit management (PBM) and medical infusion carve-out models. This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20200714005133/en/ AscellaHealth Webinar Series Episode 2 Speakers (Graphic: Business Wire) Episode …

CVS in the headlines: 14 updates | Becker’s Hospital Review | 7/13/2020

… This is not a comprehensive list. Items are listed in chronological order from most to least recent. CVS Health added five digital health services to its Point Solutions Management platform, through which CVS Caremark pharmacy benefit management clients can cover the costs of digital health tools for employees. More articles on pharmacy: © Copyright ASC COMMUNICATIONS 2020. Interested in LINKING to or REPRINTING this content? View our policies by clicking here …

China Jo-Jo Drugstores Reports Fiscal Year 2020 Financial Results | PR Newswire | 7/10/2020

… we were able to promote our sales. As a result, our sales via these e-commerce platforms increased by 58.3% period over period. The sales via our official website were primarily made by certain pharmacy benefit management providers and insurance companies. For example, we have signed a service contract with Yingda Taihe Life Insurance Co. Ltd. (“Yingda”), a national insurance company. State Grid Corporation of China has bought health insurance …

Rite Aid Announces Early Results and Increase in the Maximum Amount and Exchange Consideration of its Previously Announced Exchange Offer and Related Consent Solicitation | Business Wire | 7/10/2020

… and distribution centers or undertake additional refinancing activities, which could result in further charges; our ability to manage expenses and our investments in working capital; the continued impact of gross margin pressure in the pharmacy benefit management (“PBM”) industries due to continued consolidation and client demand for lower prices while providing enhanced service offerings; risks related to compromises of our information or payment systems or unauthorized access to confidential or …

Study Revealed Which Players May Turn Game – Jewish Market Reports | 7/8/2020

Augmented Reality (AR) in healthcare has been transforming the medical device and medicine sector at the same time. AR is a concept where the real-life elements after recognizing the environment are augmented by additional visual information. Right from pharmacy benefit management to medical training, AR in healthcare is making a substantial impact on the healthcare business. Apart from saving lives of patients, existing procedures in healthcare organizations can be …

Regeneron Announces Manufacturing and Supply Agreement for BARDA and U.S. Department of Defense for REGN-COV2 Anti-Viral Antibody Cocktail | PR Newswire | 7/7/2020

… voluntary) on the commercial success of Regeneron’s Products and product candidates; the availability and extent of reimbursement of Regeneron’s Products from third-party payers, including private payer healthcare and insurance programs, health maintenance organizations, pharmacy benefit management companies, and government programs such as Medicare and Medicaid; coverage and reimbursement determinations by such payers and new policies and procedures adopted by such payers; competing drugs and product candidates that may be …

Doctors HealthCare Plans, Inc. Selects Edifecs Hosted Encounter Management Solution | Business Wire | 7/7/2020

… special-markets/edifecs-for-smb/edifecs-for-smb-overview/ . About Edifecs Edifecs develops innovative, cost-cutting information technology solutions to transform the global healthcare marketplace. Since 1996, Edifecs technology has helped healthcare providers, insurers, pharmacy benefit management companies and other trading partners trim waste, reduce costs and increase revenues. More than 350 healthcare customers today use Edifecs solutions to simplify and unify financial and clinical transactions. In addition, Edifecs develops …

Doctors HealthCare Plans, Inc. Selects Edifecs Hosted Encounter Management Solution | Business & Finance | heraldchronicle.com | Business Wire | 7/7/2020

… special-markets/edifecs-for-smb/edifecs-for-smb-overview/ . About Edifecs Edifecs develops innovative, cost-cutting information technology solutions to transform the global healthcare marketplace. Since 1996, Edifecs technology has helped healthcare providers, insurers, pharmacy benefit management companies and other trading partners trim waste, reduce costs and increase revenues. More than 350 healthcare customers today use Edifecs solutions to simplify and unify financial and clinical transactions. In addition, Edifecs develops …

Regeneron Announces Start of REGN-COV2 Phase 3 COVID-19 Prevention Trial in Collaboration with National Institute of Allergy and Infectious Diseases (NIAID) | PR Newswire | 7/6/2020

… voluntary) on the commercial success of Regeneron’s Products and product candidates; the availability and extent of reimbursement of Regeneron’s Products from third-party payers, including private payer healthcare and insurance programs, health maintenance organizations, pharmacy benefit management companies, and government programs such as Medicare and Medicaid; coverage and reimbursement determinations by such payers and new policies and procedures adopted by such payers; competing drugs and product candidates that may be …

Anthem’s IngenioRx PBM to acquire data-driven pharmacy management company ZipDrug | FierceHealthcare | 7/6/2020

… Express Scripts brought the country’s largest PBM under the roof of a big national insurer. The insurance industry’s leading force, UnitedHealth Group, is also a massively diverse company that includes a national health plan, pharmacy benefit management , provider services and others …

Global Pharmacy Benefit Management (PBM) Market 2020–2026 | Analysis by Forecast, Growth Opportunities, Major Key Players, Revenues During Covid-19 Outbreak | 7/3/2020

Global Pharmacy Benefit Management (PBM) Sales Market (Sales,Revenue and competitors Analysis of Major Market) from 2014-2026 ” the new research report published by kandjmarketresearch.com and it spreads across 114 Pages, with summarizing Top companies and supports with tables and figures. The forecasts featured in the report have been derived using proven research methodologies and expectations. By doing so, the research report helps as a source of analysis and information for …

NuGenerex Immuno-Oncology Announces Board of Directors | 7/1/2020

… traded holding company, specializing in financial services and technology software companies. Previously, he served as Corporate Counsel for a major health system with $1 Billion in annual revenues, and General Counsel for a National Pharmacy Benefit Management Company that includes mail and specialty drug dispensing. Mr. Crisci brings a broad range of capabilities with his legal, business, financial, and regulatory background to facilitate mergers & acquisitions, joint venture and development agreements …

NuGenerex Immuno-Oncology Announces Board of Directors Other OTC:GNBT | Globe Newswire | 7/1/2020

… traded holding company, specializing in financial services and technology software companies. Previously, he served as Corporate Counsel for a major health system with $1 Billion in annual revenues, and General Counsel for a National Pharmacy Benefit Management Company that includes mail and specialty drug dispensing. Mr. Crisci brings a broad range of capabilities with his legal, business, financial, and regulatory background to facilitate mergers & acquisitions, joint venture and development agreements …

CVS reportedly creating group purchasing organization for PBM business | Healthcare Dive | 7/1/2020

Healthcare behemoth CVS Health is reportedly launching its own group purchasing organization, called Zinc, for its pharmacy benefit management business, according to a recent Nephron Research report in Drug Channels . Details around the GPO are vague, but it’s reportedly similar to Ascent Health Services, a GPO launched by CVS rival PBM Express Scripts last year. Ascent does rebate negotiations for Cigna-owned Express Scripts, along with Kroger Prescription Plans, a …

Report on PBM Market Forecasts 7% CAGR Between 2019-2025 | 6/30/2020

A new report from Arizton forecasts a compound annual growth rate of 7 percent for the pharmacy benefit management market between 2019-2025. The report spotlights a number of companies, including Abarca Health, BeneCard PBF, CVS Caremark and Express Scripts. “With a high number of consumers being enrolled in high-deductible health plans, there is a need for coordinated and broad effort to fix loopholes,” a description of the report states …

6 Pillars of Pharmacy Benefit Plan Design (Rerun) | 6/30/2020

6 Pillars of Pharmacy Benefit Plan Design (Rerun) In less than two decades, transparent third-party prescription claims adjudication has evolved into the extremely profitable and opaque pharmacy benefit management industry of today. PBMs make most of the value decisions that plan sponsors are unqualified for or choose not to make. This wouldn’t be a problem except for the fact that most PBMs are non-fiduciary, which means their interests …

MindMed Building Diverse Pipeline and Leadership Position in Psychedelic Inspired Medicines Industry | PR Newswire | 6/27/2020

… voluntary) on the commercial success of MindMed’s Products and product candidates; the availability and extent of reimbursement of MindMed’s Products from third-party payers, including private payer healthcare and insurance programs, health maintenance organizations, pharmacy benefit management companies, and government programs such as Medicare and Medicaid; coverage and reimbursement determinations by such payers and new policies and procedures adopted by such payers; competing drugs and product candidates that may be …

Rite Aid Announces Exchange Offer for Up to $750 Million Principal Amount of its Senior Notes Due 2023 and Related Consent Solicitation | Business Wire | 6/25/2020

… and distribution centers or undertake additional refinancing activities, which could result in further charges; our ability to manage expenses and our investments in working capital; the continued impact of gross margin pressure in the pharmacy benefit management (“PBM”) industries due to continued consolidation and client demand for lower prices while providing enhanced service offerings; risks related to compromises of our information or payment systems or unauthorized access to confidential or …

CVS to offer employers COVID-19 testing program as U.S. cases rise | 6/25/2020

… has increased demand in recent weeks for testing workers on a regular basis, such as every two weeks or every month, said Troy Brennan, chief medical officer of the company, which operates pharmacies, a pharmacy benefit management (PBM) service and the Aetna insurance plan. “The general perception is that there is not going to be a sustained lull over the course of the summer, and in fact it looks like …

MindMed Developing IP For Personalized Psychedelic Assisted Therapies | PR Newswire | 6/24/2020

… voluntary) on the commercial success of MindMed’s Products and product candidates; the availability and extent of reimbursement of MindMed’s Products from third-party payers, including private payer healthcare and insurance programs, health maintenance organizations, pharmacy benefit management companies, and government programs such as Medicare and Medicaid; coverage and reimbursement determinations by such payers and new policies and procedures adopted by such payers; competing drugs and product candidates that may be …

Pear Therapeutics and RemedyOne Announce Pharmacy Benefit Manager Coverage for Prescription Digital Therapeutics reSET® & reSET-O® for People with Substance and Opioid Use Disorders | 6/24/2020

… and reSET-O®, the first two prescription digital therapeutics (PDTs) to receive authorization from the U.S. Food and Drug Administration (FDA) to treat disease. This marks an important milestone for PDTs and for the pharmacy benefit management (PBM) industry to implement coverage within existing benefits, formulary design, and standard pharmacy claims processing. This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20200624005428/en/ “RemedyOne was …

COVID-19

Payers Can Use Telehealth to Increase Convenience for Members | HealthPayer Intelligence | 7/15/2020

COVID-19 pandemic underscored the importance of providing accessible care, not just in times of need, but always,” the study stated. CVS Health emphasized how its HealthHUBs seek to meet that need. The organization anticipates having 1,500 HealthHUBS open by 2021, providing preventive care, primary care services, and chronic disease management support. CVS Health announced the launch of first of these sites in 2019 along with CVS Health’s new pharmacy …

URAC

ENVISIONRX ONCE AGAIN RECOGNIZED FOR ITS COMMITMENT TO QUALITY BY URAC | Globe Newswire | 7/14/2020

Approach to pharmacy care improves outcomes for plan sponsors and members July 14, 2020 09:00 ET Source: EnvisionRxOptions Twinsburg, OH, July 14, 2020 (GLOBE NEWSWIRE) – EnvisionRx , a pharmacy benefit manager (PBM) and division of EnvisionRxOptions, a wholly owned subsidiary of Rite Aid (NYSE: RAD), today announced it has received renewal of the Drug Therapy Management and Pharmacy Benefit Management accreditations from URAC, both of which the company has held since …

Medicaid

Doctors HealthCare Plans, Inc. Selects Edifecs Hosted Encounter Management Solution | Business & Finance | heraldchronicle.com | Business Wire | 7/7/2020

… SMB (small and mid-tier) solution designed specifically for managed care plans operating in Medicare Advantage and/or within managed Medicaid lines of business. With this entirely hosted, scalable and cost-effective solution, Edifecs will … marketplace. Since 1996, Edifecs technology has helped healthcare providers, insurers, pharmacy benefit management companies and other trading partners trim waste, reduce costs and increase revenues. More than 350 healthcare customers today use Edifecs solutions to …

Food and Drug Administration

Regeneron Announces Manufacturing and Supply Agreement for BARDA and U.S. Department of Defense for REGN-COV2 Anti-Viral Antibody Cocktail | PR Newswire | 7/7/2020

… that the product could be made available immediately in the United States if clinical trials are successful and the U.S. Food and Drug Administration (FDA) grants Emergency Use Authorization (EUA) or product approval. The agreement … including private payer healthcare and insurance programs, health maintenance organizations, pharmacy benefit management companies, and government programs such as Medicare and Medicaid; coverage and reimbursement determinations by such payers and new policies and procedures adopted …

Department of Health and Human Services

Regeneron Announces Manufacturing and Supply Agreement for BARDA and U.S. Department of Defense for REGN-COV2 Anti-Viral Antibody Cocktail | PR Newswire | 7/7/2020

… Research and Development Authority (BARDA), part of the Office of the Assistant Secretary for Preparedness and Response at the U.S. Department of Health and Human Services, and the Department of Defense Joint Program Executive Office … including private payer healthcare and insurance programs, health maintenance organizations, pharmacy benefit management companies, and government programs such as Medicare and Medicaid; coverage and reimbursement determinations by such payers and new policies and procedures adopted …

Medicare Advantage

Private equity pushes into healthcare: 8 latest deals | Becker’s Hospital Review | 6/18/2020

Medicare Advantage HMO plan. 2. Osceola Capital partnered with management to recapitalize Central Medical Group, a Flanders, N.J.-based provider of outsourced equipment management solutions for hospices. 3. Parthenon Capital invested in RxSense, a provider of pharmacy benefit management solutions. 4. CareCentrix, a health benefits manager owned by Summit Partners, acquired Turn-Key Health, a Philadelphia-based palliative care company serving health plans, hospitals and physicians. 5. Adare Pharma, a …

Medicare

Private equity pushes into healthcare: 8 latest deals | Becker’s Hospital Review | 6/18/2020

Medicare Advantage HMO plan. 2. Osceola Capital partnered with management to recapitalize Central Medical Group, a Flanders, N.J.-based provider of outsourced equipment management solutions for hospices. 3. Parthenon Capital invested in RxSense, a provider of pharmacy benefit management solutions. 4. CareCentrix, a health benefits manager owned by Summit Partners, acquired Turn-Key Health, a Philadelphia-based palliative care company serving health plans, hospitals and physicians. 5. Adare Pharma, a …

Community Health

COVID-19 Shifts Consumer Behavior, Attitudes Toward Health Care Services | PR Newswire | 5/21/2020

… delaying in-person care and embracing virtual care, according to a new national survey released today by the Alliance of Community Health Plans (ACHP) and AMCP, conducted by Leede Research. Respondents cite their doctor as … 300 million Americans served by private and public health plans, pharmacy benefit management firms, and emerging care models. Visit www.amcp.org . SOURCE AMCP; ACHP Related Links http://www.amcp.org …

Biosimilars

AMCP and AMCP Foundation Announce 2020 Award Winners in Managed Care Pharmacy | PR Newswire | 5/12/2020

… 2014, he served on the AMCP Board of Directors where he was instrumental in the creation of the Biologics and Biosimilars Collective Intelligence Consortium (BBCIC). Distinguished Service Award: Recipient Richard A. Zabinski , PharmD, FAMCP, is … 300 million Americans served by private and public health plans, pharmacy benefit management firms, and emerging care models. Visit www.amcp.org . About AMCP Foundation Established in 1990, the 501(c)3 nonprofit AMCP Foundation is the …

NCQA

ENVISIONRX CONTINUES TO ACHIEVE RECOGNITION FOR EXCELLENCE IN MANAGING PHARMACY BENEFITS | Globe Newswire | 3/31/2020

NCQA Accreditation and Certification add to the pharmacy benefit manager’s growing list of industry recognitions March 31, 2020 10:43 ET Source: EnvisionRxOptions TWINSBURG, Ohio, March 31, EnvisionRx , a pharmacy benefit manager (PBM) and division of … those the company already holds, including accreditations from URAC for Pharmacy Benefit Management and Drug Therapy Management. The pharmacies division of EnvisionRxOptions also holds accreditations for its mail and specialty pharmacies, including URAC for Mail …

National Committee for Quality Assurance

ENVISIONRX CONTINUES TO ACHIEVE RECOGNITION FOR EXCELLENCE IN MANAGING PHARMACY BENEFITS | Globe Newswire | 3/31/2020

National Committee for Quality Assurance (NCQA), a private, nonprofit organization dedicated to improving healthcare quality that accredits and certifies a wide range of healthcare organizations. These achievements add to those the company already holds, including accreditations from URAC for Pharmacy Benefit Management and Drug Therapy Management. The pharmacies division of EnvisionRxOptions also holds accreditations for its mail and specialty pharmacies, including URAC for Mail Order and Specialty Pharmacy Services, Specialty …

CDC

CDC orders rules relaxed for home delivery pharmacy medication during the Coronavirus Pandemic | PRWeb | 3/24/2020

CDC orders rules relaxed for home delivery pharmacy medication during the Coronavirus Pandemic Share Article With adults 60 years and older most at risk during the pandemic, and 85% of this demographic in the U.S … and managed systems and expanded in 1998 to full-service pharmacy benefit management through the acquisition of NextGen PBM. Today, the ProCare companies also include two affiliated mail-order and specialty pharmacies and are one …

Formulary Management

CVS Health (NYSE:CVS) Earns Buy Rating from UBS Group | 12/4/2019

pharmacy benefit management solutions, such as plan design and administration, formulary management, retail pharmacy network management, mail order pharmacy, specialty pharmacy and infusion, Medicare Part D, clinical, disease management, and medical spend management services …

Home Based Primary Care

Centene Corporation Announces Extension of Exchange Offers and Consent Solicitations for WellCare Notes | PR Newswire | 12/3/2019

ST. LOUIS , Dec. 2, Centene Corporation (NYSE: CNC ) (“Centene”) announced today the extension of the expiration date of the offers to exchange (the “Exchange Offers”) notes (the “WellCare Notes”) issued by WellCare Health Plans, Inc. (NYSE: WCG ) (“WellCare”) for up to $1,950,000,000 aggregate principal amount of new notes to be issued by Centene (the “Centene Notes”) and cash and the related consent solicitations (the “Consent Solicitations”) being made by Centene …

Care Management Software

Centene Corporation Announces Extension of Exchange Offers and Consent Solicitations for WellCare Notes | PR Newswire | 12/3/2019

… commercial health plans. Centene operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, correctional healthcare services, dental benefits management, commercial programs, home-based primary care services, life and health management, vision benefits management, pharmacy benefits management, specialty pharmacy and telehealth services. Cautionary Statement Regarding Forward-Looking Statements …

Clinical Data

New England Journal of Medicine Publishes Results of Ebola Clinical Trial Confirming Superiority of Regeneron’s REGN-EB3 to ZMapp in Preventing Ebola Deaths | PR Newswire | 11/28/2019

… protocol was amended after the World Health Organization (WHO) held an Ad-Hoc Expert Consultation to assess all preclinical and clinical data on available investigational products, and recommended the addition of REGN-EB3 as a … including private payer healthcare and insurance programs, health maintenance organizations, pharmacy benefit management companies, and government programs such as Medicare and Medicaid; coverage and reimbursement determinations by such payers and new policies and procedures adopted …

Behavioral Health

Magellan Rx Management’s MRx Navigate Offers Integrated Care Management, Focused On Customer And Member Healthcare Needs | Health IT Outcomes | 11/25/2019

Magellan Rx Management, the pharmacy benefit management (PBM) division of Magellan Health, Inc. (NASDAQ: MGLN), has launched MRx Navigate, a comprehensive care management program that offers integrated, high-touch and high-tech solutions, focusing on … acute or ongoing complex conditions and connects members with nurses, behavioral health professionals, and clinical pharmacists. Through these four programs, MRx Navigate eliminates gaps in care and improves adherence through the use of advanced digital …

Health Management

Magellan Rx Management’s MRx Navigate Offers Integrated Care Management, Focused On Customer And Member Healthcare Needs | Health IT Outcomes | 11/25/2019

Magellan Rx Management, the pharmacy benefit management (PBM) division of Magellan Health, Inc. (NASDAQ: MGLN), has launched MRx Navigate, a comprehensive care management program that offers integrated, high-touch and high-tech solutions, focusing on … through educational tools and resources. Navigate PopHealth is a population health management program that identifies gaps in care and implements a plan to reduce or eliminate those gaps. Navigate UM is a utilization management program …

Utilization Management

Magellan Rx Management’s MRx Navigate Offers Integrated Care Management, Focused On Customer And Member Healthcare Needs | Health IT Outcomes | 11/25/2019

Magellan Rx Management, the pharmacy benefit management (PBM) division of Magellan Health, Inc. (NASDAQ: MGLN), has launched MRx Navigate, a comprehensive care management program that offers integrated, high-touch and high-tech solutions, focusing on … to reduce or eliminate those gaps. Navigate UM is a utilization management program that ensures appropriate care and reduces cost across medical and behavioral services, concurrent review of inpatient admission, transition of care assessment, and …

Population Health

Magellan Rx Management’s MRx Navigate Offers Integrated Care Management, Focused On Customer And Member Healthcare Needs | Health IT Outcomes | 11/25/2019

Magellan Rx Management, the pharmacy benefit management (PBM) division of Magellan Health, Inc. (NASDAQ: MGLN), has launched MRx Navigate, a comprehensive care management program that offers integrated, high-touch and high-tech solutions, focusing on … life through educational tools and resources. Navigate PopHealth is a population health management program that identifies gaps in care and implements a plan to reduce or eliminate those gaps. Navigate UM is a utilization management …

Healthcare Marketplace

Excelera Announces Unique, Transparent Pharmacy Benefit Solution, Prioritizing Patient Outcomes Over Profits | PR Newswire | 11/21/2019

… Patient Outcomes Over Profits Anchored in a nationwide network of leading health systems, Excelera’s new pharmacy benefit solution uniquely aligns pharmacy benefit management across the stakeholder continuum News provided by Nov 21, 2019, 06:00 ET … consolidated into an exclusive group of dominant players in the healthcare marketplace that reap profits by chasing manufacturer rebates, marking up prices to community pharmacies and forcing patients to use PBM-owned pharmacies. Further, inflexible …

Digital Therapeutics

Luisa Beltran wrote a new post, Oak HC/FT-backed WithMe Health expands leadership team, on the site PE Hub | 11/20/2019

… strategy across the sales, marketing and customer success teams. He was previously the Chief Commercial Officer at Big Health, a digital therapeutics company focused on mental health, and before that worked as an early-stage … operators steeped in tech-enabled healthcare delivery, managed care and pharmacy benefit management. Founded in 2018, the company is headquartered in San Mateo, California and has received $20M in funding from venture growth equity firm …

Children's Health

Centene Corporation Announces Offering of Senior Notes | PR Newswire | 11/15/2019

… multi-national healthcare enterprise that provides a portfolio of services to government sponsored and commercial healthcare programs, focusing on under-insured and uninsured individuals. Many receive benefits provided under Medicaid, including the State Children’s Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long-Term Services and Supports (LTSS), in addition to other state-sponsored programs, Medicare (including the Medicare prescription drug benefit commonly …

Provider Engagement

Pulse8 Presenting as a Panelist on Provider-Health Plan Relationships During the RISE Risk Adjustment Forum in Scottsdale, AZ - Business Wire | 11/11/2019

… part of Veradigm™, an Allscripts (NASDAQ: MDRX) business unit. This year’s forum will include Pulse8’s Caralyn Maerz , Director of Provider Engagement, as a panelist to discuss leveling up your provider-health plan relationships on … visibility into the efficacy of your Risk Adjustment, Quality, and Pharmacy Benefit Management programs. We enable health plans and providers to eliminate waste and achieve the greatest financial impact in the Medicare Advantage, Medicaid, and …

Member Engagement

Pulse8 Presenting as a Panelist on Provider-Health Plan Relationships During the RISE Risk Adjustment Forum in Scottsdale, AZ - Business Wire | 11/11/2019

… new and innovative ways to fight off provider and member fatigue and come away with new ideas to jointly improve member engagement and patient care Recognize opportunities to collaborate to optimize workflows on both sides … visibility into the efficacy of your Risk Adjustment, Quality, and Pharmacy Benefit Management programs. We enable health plans and providers to eliminate waste and achieve the greatest financial impact in the Medicare Advantage, Medicaid, and …

CVS

Payers Can Use Telehealth to Increase Convenience for Members | HealthPayer Intelligence | 7/15/2020

… care delivery and prefer to turn to telehealth and digital solutions, in part, as the answer, according to a recent CVS Health study . CVS Health fielded the survey in March 2020 and garnered 1,000 respondents … of these sites in 2019 along with CVS Health’s new pharmacy benefit management service. Beyond physical locations, however, convenience attracted consumers and providers alike to digital health and telehealth solutions. Nearly half of the consumer …

CVS Health

Payers Can Use Telehealth to Increase Convenience for Members | HealthPayer Intelligence | 7/15/2020

… care delivery and prefer to turn to telehealth and digital solutions, in part, as the answer, according to a recent CVS Health study . CVS Health fielded the survey in March 2020 and garnered 1,000 respondents … of these sites in 2019 along with CVS Health’s new pharmacy benefit management service. Beyond physical locations, however, convenience attracted consumers and providers alike to digital health and telehealth solutions. Nearly half of the consumer …

Rite Aid

ENVISIONRX ONCE AGAIN RECOGNIZED FOR ITS COMMITMENT TO QUALITY BY URAC | Globe Newswire | 7/14/2020

Approach to pharmacy care improves outcomes for plan sponsors and members July 14, 2020 09:00 ET Source: EnvisionRxOptions Twinsburg, OH, July 14, 2020 (GLOBE NEWSWIRE) – EnvisionRx , a pharmacy benefit manager (PBM) and division of EnvisionRxOptions, a wholly owned subsidiary of Rite Aid (NYSE: RAD), today announced it has received renewal of the Drug Therapy Management and Pharmacy Benefit Management accreditations from URAC, both of which the company has held since …

AscellaHealth

Self-Insured Employers, Plan Sponsors Discover Value of Specialty PBM & Medical Infusion Carve-Outs: Largest TPAs, SIIA Regulatory Expert Present Episode 2, AscellaHealth Educational Webinars | Business & Finance | manchestertimes.com | Business Wire | 7/14/2020

BERWYN, Pa.–(BUSINESS WIRE)–Jul 14, 2020– AscellaHealth , a national specialty pharmacy benefit manager (SPBM TM ) serving commercial, Medicare and Medicaid segments, in collaboration with Leaf Health , will present strategies for self-insured employers and … PBM Model” focuses upon cost-curbing solutions related to specialty pharmacy benefit management (PBM) and medical infusion carve-out models. This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20200714005133 …

CVS Caremark

CVS in the headlines: 14 updates | Becker’s Hospital Review | 7/13/2020

CVS Caremark pharmacy benefit management clients can cover the costs of digital health tools for employees. More articles on pharmacy: © Copyright ASC COMMUNICATIONS 2020. Interested in LINKING to or REPRINTING this content? View our policies by clicking here . This routine screening saves lives, but many Americans go without — Geisinger is trying to change that Featured Whitepapers Contact Us 1.800.417.2035 Copyright © 2020 Becker’s Healthcare. All Rights Reserved. Interested in linking to …

Regeneron Pharmaceuticals

Regeneron Announces Manufacturing and Supply Agreement for BARDA and U.S. Department of Defense for REGN-COV2 Anti-Viral Antibody Cocktail | PR Newswire | 7/7/2020

TARRYTOWN, N.Y. , July 7, Regeneron Pharmaceuticals, Inc. (NASDAQ: REGN ) today announced that, as part of Operation Warp Speed, the Biomedical Advanced Research and Development Authority (BARDA), part of the Office of the Assistant Secretary for … including private payer healthcare and insurance programs, health maintenance organizations, pharmacy benefit management companies, and government programs such as Medicare and Medicaid; coverage and reimbursement determinations by such payers and new policies and procedures adopted …

Regeneron

Regeneron Announces Manufacturing and Supply Agreement for BARDA and U.S. Department of Defense for REGN-COV2 Anti-Viral Antibody Cocktail | PR Newswire | 7/7/2020

TARRYTOWN, N.Y. , July 7, Regeneron Pharmaceuticals, Inc. (NASDAQ: REGN ) today announced that, as part of Operation Warp Speed, the Biomedical Advanced Research and Development Authority (BARDA), part of the Office of the Assistant Secretary for … including private payer healthcare and insurance programs, health maintenance organizations, pharmacy benefit management companies, and government programs such as Medicare and Medicaid; coverage and reimbursement determinations by such payers and new policies and procedures adopted …

UnitedHealth

Anthem’s IngenioRx PBM to acquire data-driven pharmacy management company ZipDrug | FierceHealthcare | 7/6/2020

UnitedHealth Group, is also a massively diverse company that includes a national health plan, pharmacy benefit management, provider services and others …

UnitedHealth Group

Anthem’s IngenioRx PBM to acquire data-driven pharmacy management company ZipDrug | FierceHealthcare | 7/6/2020

… UnitedHealth Group, is also a massively diverse company that includes a national health plan, pharmacy benefit management, provider services and others …

IngenioRx

Anthem’s IngenioRx PBM to acquire data-driven pharmacy management company ZipDrug | FierceHealthcare | 7/6/2020

Anthem’s pharmacy benefit manager IngenioRx will acquire ZipDrug, a data-driven pharmacy management company. The acquisition expands IngenioRx’s offerings to include a platform that directs consumers to pharmacies with high-performing pharmacies and that offers … a massively diverse company that includes a national health plan, pharmacy benefit management, provider services and others …

Pfizer

NuGenerex Immuno-Oncology Announces Board of Directors Other OTC:GNBT | Globe Newswire | 7/1/2020

… advised on equity financings, and implemented the broad strategic vision for the Company. Mr. Moscato has worked and consulted for Pfizer in several capacities from sales and marketing to new drug discovery & development to licensing … Billion in annual revenues, and General Counsel for a National Pharmacy Benefit Management Company that includes mail and specialty drug dispensing. Mr. Crisci brings a broad range of capabilities with his legal, business, financial, and …

Express Scripts

CVS reportedly creating group purchasing organization for PBM business | Healthcare Dive | 7/1/2020

Healthcare behemoth CVS Health is reportedly launching its own group purchasing organization, called Zinc, for its pharmacy benefit management business, according to a recent Nephron Research report in Drug Channels . Details around the GPO are vague, but it’s reportedly similar to Ascent Health Services, a GPO launched by CVS rival PBM Express Scripts last year. Ascent does rebate negotiations for Cigna-owned Express Scripts, along with Kroger Prescription Plans, a …

Walgreens Healthcare

CVS reportedly creating group purchasing organization for PBM business | Healthcare Dive | 7/1/2020

pharmacy benefit management business, according to a recent Nephron Research report in Drug Channels . Details around the GPO are vague, but it’s reportedly similar to Ascent Health Services, a GPO launched by CVS rival PBM Express Scripts last year. Ascent does rebate negotiations for Cigna-owned Express Scripts, along with Kroger Prescription Plans, a PBM owned by the grocer, and Prime Therapeutics , a Blues- and Walgreens-affiliated PBM. CVS declined …

Big Health

Big Health Raises $39 Million in Series B Financing from Gilde Healthcare, Morningside Ventures, Kaiser Permanente Ventures, and Octopus Ventures | PR Newswire | 6/18/2020

SAN FRANCISCO , June 18, Big Health , the global leader in digital therapeutics dedicated to helping millions back to good mental health, today announced it has raised $39 million in a Series B financing, led by … add Big Health’s Sleepio ™ - for poor sleep - to the CVS pharmacy benefit management formulary, which simplifies employer sign-up and reimbursement. In early April of this year, in response to the Covid-19 pandemic, the …

Gilead

Previously Vilified, Big Pharma Steps Up in COVID-19 Fight | PRWeb | 6/8/2020

… from all across the industry show just how far Big Pharma is willing to go to help protect American lives. Gilead, the company that developed the antiviral drug remdesivir, has already pledged 1.5 million doses … and managed systems, and expanded in 1998 to full-service pharmacy benefit management through the acquisition of NextGen PBM. Today, the ProCare companies also include two affiliated mail-order and specialty pharmacies, ProCare PharmacyCare, and …

OptumRx

AMCP and AMCP Foundation Announce 2020 Award Winners in Managed Care Pharmacy | PR Newswire | 5/12/2020

… recipients are: Steven G. Avey Award: Recipient David Calabrese , RPh, MHP, is senior vice president and chief pharmacy officer at OptumRx. Calabrese is a sought out thought leader who is widely published and speaks at … 300 million Americans served by private and public health plans, pharmacy benefit management firms, and emerging care models. Visit www.amcp.org . About AMCP Foundation Established in 1990, the 501(c)3 nonprofit AMCP Foundation is the …

GoodRx

CerpassRx and GoodRx Launches Employee Relief Program in response to COVID-19 | 4/27/2020

DALLAS , April 27, CerpassRx, a Texas -based pharmacy benefit management company, announced a partnership with GoodRx and the launch of the Employee Relief Program to assist businesses impacted by COVID-19. CerpassRx and GoodRx understand that during these uncertain times businesses are looking to offer discounted healthcare options to their employees. CerpassRx took this opportunity to team up with GoodRx to create an employer program that provides GoodRx Gold at …

Optum

UnitedHealth won’t seek federal aid because of outbreak | Star Tribune | 4/15/2020

Optum segment also runs one of the nation’s largest pharmacy benefit management operations as well as a growing number of clinics and urgent care and surgery centers. Analysts expect those surgery centers to see a drop in business as patients cancel or postpone elective procedures. That could help the insurance operation, depending on how many of those claims are merely pushed back to the second half of the year. But …

Excelera

Excelera Announces Unique, Transparent Pharmacy Benefit Solution, Prioritizing Patient Outcomes Over Profits | PR Newswire | 11/21/2019

Sverige Excelera Announces Unique, Transparent Pharmacy Benefit Solution, Prioritizing Patient Outcomes Over Profits Anchored in a nationwide network of leading health systems, Excelera’s new pharmacy benefit solution uniquely aligns pharmacy benefit management across the stakeholder continuum News provided by Nov 21, 2019, 06:00 ET Share this article MINNEAPOLIS , Nov. 21, 2019 /PRNewswire/ – Excelera ® , the company behind the Excelera Network, a nationwide network of leading health systems and academic medical centers …

ExceleraRx

Excelera Announces Unique, Transparent Pharmacy Benefit Solution, Prioritizing Patient Outcomes Over Profits | PR Newswire | 11/21/2019

… Patient Outcomes Over Profits Anchored in a nationwide network of leading health systems, Excelera’s new pharmacy benefit solution uniquely aligns pharmacy benefit management across the stakeholder continuum News provided by Nov 21, 2019, 06:00 ET … program. To learn more about the Excelera Network, visit https://www.excelerarx.com/ About The Excelera ® Network The Excelera ® Network is comprised of integrated delivery networks, health systems, and large academic medical centers with a deep commitment …

Convey Health Solutions

HealthScape Advisors Ranked in Top 10 in Modern Healthcare’s 2019 Best Places to Work in Healthcare | PR Newswire | 11/18/2019

CHICAGO , Nov. 18, 2019 /PRNewswire/ – HealthScape Advisors, a Convey Health Solutions company advising clients in the healthcare industry, has been recognized as a Top 10 Supplier in Modern Healthcare’s 2019 Best Places to Work in … include some of the nation’s leading health insurance plans and pharmacy benefit management firms. Their healthcare-focused teams help several million Americans each year to navigate the complex Medicare Advantage and Part D landscape. Media …

DaVita

Wall Street near highs after upbeat earnings run | Yahoo News | 11/6/2019

pharmacy benefit management unit. But shares of Match Group Inc MTCH.O fell 10.4% after the Tinder-owner forecast fourth-quarter revenue below estimates in the face of stiff competition from rival online dating services. Its parent firm, IAC/InterActiveCorp IAC.O , dropped 7.1%. Shares of DaVita Inc DVA.N rose 7.3% after the company reported better-than-expected third-quarter results. HP Inc HPQ.N jumped 8.4% after a report that Xerox Holdings …

Walgreens Boots Alliance

Dr. Drugstore Will See You Now | Managed Care Magazine | 11/6/2019

… easily accessible medical care will pay off by coordinating care and, ultimately, reduce health care costs. Humana has bedfellowed with Walgreens Boots Alliance to open senior-focused primary care clinics inside Walgreens locations. CVS Health … 39 million members and provided medical insurance, dental insurance, and pharmacy benefit management services. CVS Health says it has more than 9,900 retail locations in this country (including Puerto Rico) and Brazil, with 1,100 MinuteClinics …

McKesson

CVS Health’s Specialty Gain Is McKesson’s Pain | 11/5/2019

Last week, McKesson released its earnings for the third calendar quarter of 2019. (See the links below.) The company revealed unexpectedly high revenue growth in its distribution business—but little incremental profit from these new … the overall industry. Consolidation and concentration in the pharmacy and pharmacy benefit management (PBM) industries continue to pressure wholesalers’ profits. Manufacturers and smaller customers should get ready for the fryer. Robble robble! McREAD ME As …

OptumHealth

UnitedHealth Group: Solid Candidate For Dividend Growth Investors - UnitedHealth Group Incorporated (NYSE:UNH) | Seeking Alpha | 11/5/2019

… OptumHealth, OptumInsight, and OptumRx. OptumHealth offers IT based healthcare services consulting to over 14 million patients through physicians and primary, urgent and surgery care centers. OptumInsight offers analytics, research, consulting, and managed services to hospitals, physicians, health plans, etc. OptumRx offers pharmacy benefit management. UnitedHealth Growth and Profitability UnitedHealth grows the top and bottom lines by acquiring more members. The company’s business model for the United Healthcare operating unit is …

Oak HC/FT

Luisa Beltran wrote a new post, Oak HC/FT-backed WithMe Health expands leadership team, on the site PE Hub | 11/20/2019

Oak HC/FT-backed WithMe Health expands leadership team November 20, 2019 Follow @LuisaRBeltran WithMe Health , a portfolio company of Oak HC/FT, said Nov. 20 that four new executives have joined the company. They … operators steeped in tech-enabled healthcare delivery, managed care and pharmacy benefit management. Founded in 2018, the company is headquartered in San Mateo, California and has received $20M in funding from venture growth equity firm …

Centerview Partners

Avista Capital Partners to Acquire Express Scripts’ Subsidiary United BioSource | PR Newswire | 11/27/2017

… work with the UBC team to advance and expand the company’s services and help it realize its full growth potential.” Centerview Partners LLC acted as financial advisor and Bryan Cave LLP acted as legal counsel … and accessible. Headquartered in St. Louis , Express Scripts provides integrated pharmacy benefit management services, including network-pharmacy claims processing home delivery pharmacy care, specialty pharmacy care, specialty benefit management, benefit-design consultation, drug utilization review …

Merrill Lynch

Anthem Announces Final Results of its Tender Offer for Any and All of its 7.000% Notes due 2019 | Business Wire | 11/22/2017

… used in this press release and not defined herein have the meanings given to them in the Offer Documents. BofA Merrill Lynch and Deutsche Bank Securities acted as dealer managers for the Offer. For additional … non-compliance by any party with the Express Scripts, Inc. pharmacy benefit management services agreement, which could result in financial penalties; our inability to meet customer demands, and sanctions imposed by governmental entities, including the …

Oak HC/FT Partners

Diplomat to Acquire LDI Integrated Pharmacy Services | CNBC | 11/16/2017

… to acquire Leehar Distributors, LLC, doing business as LDI Integrated Pharmacy Services (LDI), from investment firms Nautic Partners, LLC and Oak HC/FT Partners LLC, and management. The transaction is expected to close in 30 … by pharmacists in 1967 and is a trusted partner for pharmacy benefit management. We serve hundreds of payor clients, including health insurers, third-party administrators, and self-insured organizations. LDI offers specialty and mail-order …

Nautic Partners

Diplomat to Acquire LDI Integrated Pharmacy Services | CNBC | 11/16/2017

… into a definitive agreement to acquire Leehar Distributors, LLC, doing business as LDI Integrated Pharmacy Services (LDI), from investment firms Nautic Partners, LLC and Oak HC/FT Partners LLC, and management. The transaction is expected … by pharmacists in 1967 and is a trusted partner for pharmacy benefit management. We serve hundreds of payor clients, including health insurers, third-party administrators, and self-insured organizations. LDI offers specialty and mail-order …

J.P. Morgan Securities

Diplomat to Acquire LDI Integrated Pharmacy Services | PR Newswire | 11/15/2017

… Diplomat’s outstanding credit facility. Honigman Miller Schwartz and Cohn, LLP, and Quarles & Brady, LLP, acted as legal counsel to Diplomat. J.P. Morgan Securities LLC acted as Diplomat’s financial advisor and JPMorgan Chase Bank, N.A. and … by pharmacists in 1967 and is a trusted partner for pharmacy benefit management. We serve hundreds of payor clients, including health insurers, third-party administrators, and self-insured organizations. LDI offers specialty and mail-order …

Morgan Stanley

DENTSPLY SIRONA (XRAY) Q3 2017 Results - Earnings Call Transcript | Seeking Alpha | 11/3/2017

… William Blair & Co. LLC Robert Patrick Jones - Goldman Sachs & Co. LLC Tycho W. Peterson - JPMorgan Securities LLC Steve C. Beuchaw - Morgan Stanley & Co. LLC Erin Wilson Wright - Credit Suisse Securities (NYSE: USA ) LLC Jeffrey D … EVP and General Counsel with Express Scripts, a $100 billion pharmacy benefit management firm that ranks 22nd on the Fortune 500 list. Keith is one of the brightest and most accomplished GCs in the entire …

Goldman Sachs

DENTSPLY SIRONA (XRAY) Q3 2017 Results - Earnings Call Transcript | Seeking Alpha | 11/3/2017

… Thierer - DENTSPLY SIRONA, Inc. Ulrich Michel - DENTSPLY SIRONA, Inc. Analysts John C. Kreger - William Blair & Co. LLC Robert Patrick Jones - Goldman Sachs & Co. LLC Tycho W. Peterson - JPMorgan Securities LLC Steve C. Beuchaw - Morgan Stanley … EVP and General Counsel with Express Scripts, a $100 billion pharmacy benefit management firm that ranks 22nd on the Fortune 500 list. Keith is one of the brightest and most accomplished GCs in the entire …

General Atlantic

Express Scripts (ESRX) to Buy eviCore, Fortify PBM Business - October 11, 2017 - Zacks.com | 10/11/2017

… General Atlantic, TA Associates and Ridgemont Equity Partners for $3.6 billion. The transaction is expected to close in the fourth quarter of 2017. eviCore provides evidence-based and integrated medical benefit management services (MBM) solutions that drive cost reduction and quality care outcomes. Notably, eviCore will operate as a standalone business unit under Express Scripts. Express Scripts’ pharmacy benefit management coupled with eviCore’s complementary medical benefits management is likely to …

TA Associates

Express Scripts (ESRX) to Buy eviCore, Fortify PBM Business - October 11, 2017 - Zacks.com | 10/11/2017

TA Associates and Ridgemont Equity Partners for $3.6 billion. The transaction is expected to close in the fourth quarter of 2017. eviCore provides evidence-based and integrated medical benefit management services (MBM) solutions that drive cost reduction and quality care outcomes. Notably, eviCore will operate as a standalone business unit under Express Scripts. Express Scripts’ pharmacy benefit management coupled with eviCore’s complementary medical benefits management is likely to build a …

Ridgemont Equity Partners

Express Scripts (ESRX) to Buy eviCore, Fortify PBM Business - October 11, 2017 - Zacks.com | 10/11/2017

Ridgemont Equity Partners for $3.6 billion. The transaction is expected to close in the fourth quarter of 2017. eviCore provides evidence-based and integrated medical benefit management services (MBM) solutions that drive cost reduction and quality care outcomes. Notably, eviCore will operate as a standalone business unit under Express Scripts. Express Scripts’ pharmacy benefit management coupled with eviCore’s complementary medical benefits management is likely to build a comprehensive patient benefit …

Kaiser Permanente

Big Health Raises $39 Million in Series B Financing from Gilde Healthcare, Morningside Ventures, Kaiser Permanente Ventures, and Octopus Ventures | PR Newswire | 6/18/2020

… 39 million in a Series B financing, led by Gilde Healthcare and joined by co-lead Morningside Ventures; existing investors Kaiser Permanente Ventures (KPV) and Octopus Ventures; and Samsung NEXT. Janke Dittmer , general partner at … add Big Health’s Sleepio ™ - for poor sleep - to the CVS pharmacy benefit management formulary, which simplifies employer sign-up and reimbursement. In early April of this year, in response to the Covid-19 pandemic, the …

Hospitals and health systems: 6 trends and issues | Becker’s Hospital Review | 11/22/2019

… is far more important than having lots of different hospitals. The sixth type of hospital that we think of as Kaiser Permanente. Here, we put Oakland, Calif.-based Kaiser Permanente in its own category. It … years ago. Each of these forays into technology, consulting, payment, pharmacy benefit management, post-acute care and provider spaces make health insurers more prevalent in the industry. A second great concern is the growing number …

Genesis Healthcare

Magellan Health’s PBM Division Unveils Care Management Plan - November 27, 2019 - Zacks.com | 11/27/2019

Magellan Health, Inc. ’s ( MGLN - Free Report ) pharmacy benefit management division Magellan Rx Management recently introduced MRx Navigate, an extensive care management program. The program includes integrated, high-touch and high-tech solutions with complete … Free Report ) , WellCare Health Plans, Inc. ( WCG - Free Report ) and Genesis Healthcare, Inc. ( GEN - Free Report ) . (Strong Buy) stocks here. Select Medical Holdings operates critical illness recovery hospitals, rehabilitation hospitals, outpatient rehabilitation clinics and occupational …

Magellan Health’s PBM Division Unveils Care Management Plan | Zacks | 11/27/2019

… you like to follow? Zacks Equity Research Cancel Read More Hide Full Article Magellan Health, Inc. ’s ( MGLN - Free Report ) pharmacy benefit management division Magellan Rx Management recently introduced MRx Navigate, an extensive care management … Free Report ) , WellCare Health Plans, Inc. ( WCG - Free Report ) and Genesis Healthcare, Inc. ( GEN - Free Report ) . You can see the complete list of today’s Zacks 1 Rank (Strong Buy) stocks here. Select Medical Holdings operates …

SSM Health

SSM Health and CSA Complete Sponsorship Transfer of Agnesian HealthCare and Monroe Clinic | Business Wire | 1/5/2018

ST. LOUIS & FOND DU LAC, Wis.- The Congregation of Sisters of St. Agnes (CSA) and SSM Health announced today they’ve successfully completed a transfer of sponsorship of CSA’s health care ministries. Agnesian HealthCare, based in … outpatient care sites, as well as a health plan and pharmacy benefit management company. In addition, the health system now has about 14,000 employees and physicians in Wisconsin – and more than 40,000 across the Midwest …

Navitus Medicare EGWP Program Receives 5-Star CMS Rating | PR Newswire | 10/17/2017

… SSM Health, is a full-service, URAC-accredited pharmacy benefit management company. As a zero-spread, full pass through pharmacy benefit manager (PBM), Navitus aligns performance with plan sponsors’ benefit goals to deliver comprehensive clinical programs and cost-saving strategies that lower drug trend and promote good member health. Navitus provides its flexible services to government entities, self-funded employers, coalitions, labor organizations, third-party administrators, and health plans, including …

Cigna

Anthem’s IngenioRx PBM to acquire data-driven pharmacy management company ZipDrug | FierceHealthcare | 7/6/2020

… deal to close were not disclosed. Anthem launched IngenioRx in mid-2019 , moving up the launch as a result of Cigna’s acquisition of the insurer’s prior PBM, Express Scripts. Anthem’s members will be covered by … a massively diverse company that includes a national health plan, pharmacy benefit management, provider services and others …

Aetna

Anthem’s IngenioRx PBM to acquire data-driven pharmacy management company ZipDrug | FierceHealthcare | 7/6/2020

Aetna includes a large national plan, a PBM with broad membership and a massive retail footprint. Cigna’s purchase of Express Scripts brought the country’s largest PBM under the roof of a big national insurer. The insurance industry’s leading force, UnitedHealth Group, is also a massively diverse company that includes a national health plan, pharmacy benefit management, provider services and others …

Molina Healthcare

Magellan Health and Molina Healthcare Enter Into Definitive Agreements to Divest Magellan Complete Care and Establish Commercial Relationship for Multiple Magellan Services | 4/30/2020

… the nation’s leaders in managing complex, high cost healthcare, today announced that it has entered into a definitive agreement with Molina Healthcare, Inc. to sell its Magellan Complete Care (MCC) business to Molina for a … certain MCC markets. Magellan Rx Management will continue the existing pharmacy benefit management relationships within MCC. The transaction is expected to be completed by the end of the first quarter of 2021 and is subject …

Magellan Health

Magellan Health and Molina Healthcare Enter Into Definitive Agreements to Divest Magellan Complete Care and Establish Commercial Relationship for Multiple Magellan Services | 4/30/2020

PHOENIX–(BUSINESS WIRE)–Apr 30, 2020– Magellan Health, Inc. (NASDAQ: MGLN), one of the nation’s leaders in managing complex, high cost healthcare, today announced that it has entered into a definitive agreement with Molina Healthcare … certain MCC markets. Magellan Rx Management will continue the existing pharmacy benefit management relationships within MCC. The transaction is expected to be completed by the end of the first quarter of 2021 and is subject …

Wellcare Health Plans

Centene Corporation Announces Extension of Exchange Offers and Consent Solicitations for WellCare Notes | PR Newswire | 12/3/2019

ST. LOUIS , Dec. 2, Centene Corporation (NYSE: CNC ) (“Centene”) announced today the extension of the expiration date of the offers to exchange (the “Exchange Offers”) notes (the “WellCare Notes”) issued by WellCare Health Plans, Inc. (NYSE: WCG ) (“WellCare”) for up to $1,950,000,000 aggregate principal amount of new notes to be issued by Centene (the “Centene Notes”) and cash and the related consent solicitations (the “Consent Solicitations”) being made by Centene …

WellCare Health

Centene Corporation Announces Extension of Exchange Offers and Consent Solicitations for WellCare Notes | PR Newswire | 12/3/2019

ST. LOUIS , Dec. 2, Centene Corporation (NYSE: CNC ) (“Centene”) announced today the extension of the expiration date of the offers to exchange (the “Exchange Offers”) notes (the “WellCare Notes”) issued by WellCare Health Plans, Inc. (NYSE: WCG ) (“WellCare”) for up to $1,950,000,000 aggregate principal amount of new notes to be issued by Centene (the “Centene Notes”) and cash and the related consent solicitations (the “Consent Solicitations”) being made by Centene …

Wellcare

Centene Corporation Announces Extension of Exchange Offers and Consent Solicitations for WellCare Notes | PR Newswire | 12/3/2019

ST. LOUIS , Dec. 2, Centene Corporation (NYSE: CNC ) (“Centene”) announced today the extension of the expiration date of the offers to exchange (the “Exchange Offers”) notes (the “WellCare Notes”) issued by WellCare Health Plans, Inc. (NYSE: WCG ) (“WellCare”) for up to $1,950,000,000 aggregate principal amount of new notes to be issued by Centene (the “Centene Notes”) and cash and the related consent solicitations (the “Consent Solicitations”) being made by Centene …

Humana

Hospitals and health systems: 6 trends and issues | Becker’s Hospital Review | 11/22/2019

Humana and private equity firms acquired Kindred Healthcare. Highmark, one of the largest insurers in the country, acquired the West Penn Allegheny Health System years ago. Each of these forays into technology, consulting, payment, pharmacy benefit management, post-acute care and provider spaces make health insurers more prevalent in the industry. A second great concern is the growing number of access points that are providing threats to health systems and …

UnitedHealthcare

Dr. Drugstore Will See You Now | Managed Care Magazine | 11/6/2019

… beneficiaries are enrolled in Medicare Advantage plans now, and Humana has about 17% of the MA market, second only to UnitedHealthcare. Seniors don’t have to be Humana members to use the senior care clinics; Partners … 39 million members and provided medical insurance, dental insurance, and pharmacy benefit management services. CVS Health says it has more than 9,900 retail locations in this country (including Puerto Rico) and Brazil, with 1,100 MinuteClinics …

Centene Corp

Centene Corporation Reports 2019 Third Quarter Results | Benzinga | 10/22/2019

ST. LOUIS , Oct. 22, 2019 /PRNewswire/ – Centene Corporation (NYSE: CNC ) announced today its financial results for the third quarter ended September 30, 2019, reporting diluted earnings per share (EPS) of $0.23 , and Adjusted Diluted EPS … care services to the underserved, while also utilizing RxAdvance’s innovative pharmacy benefit management model powered by its Collaborative PBM Cloud platform. In October 2019 , Centene’s North Carolina joint venture, Carolina Complete Health, was awarded an …

Anthem

Cigna Delivers Strong First Quarter 2019 Results, Raises Outlook | Business Wire | 5/2/2019

pharmacy benefit management clients, Anthem Inc. and Coventry Health Care, Inc. (the “transitioning clients”), net realized investment results from equity method investments, and special items. We exclude these items from this measure because they are not indicative of past or future underlying performance of the business. See Exhibit 1 for a reconciliation of consolidated adjusted revenues to total revenues. 2. Adjusted income (loss) from operations is defined as shareholders’ net …

HealthSmart

HealthSmart Appoints JC Gibson Executive Vice President of Human Resources | PRWeb | 11/10/2017

HealthSmart Appoints JC Gibson Executive Vice President of Human Resources Share Article Award winning executive to lead all aspects of human resources IRVING, Texas (PRWEB) November 10, 2017 HealthSmart is pleased to announce the appointment … all angles. This includes claims and benefits administration, provider networks, pharmacy benefit management services, business intelligence, on-site employer clinics, care management, a variety of health and wellness initiatives and web-based reporting. The Company’s …

Larry Merlo

Payers Can Use Telehealth to Increase Convenience for Members | HealthPayer Intelligence | 7/15/2020

… providers. “The pandemic has forced countless Americans to rethink their approach to health and explore different avenues of care,” said Larry Merlo, chief executive officer of CVS Health. “Whether in the community, in the home … of these sites in 2019 along with CVS Health’s new pharmacy benefit management service. Beyond physical locations, however, convenience attracted consumers and providers alike to digital health and telehealth solutions. Nearly half of the consumer …

Dea Belazi

Self-Insured Employers, Plan Sponsors Discover Value of Specialty PBM & Medical Infusion Carve-Outs: Largest TPAs, SIIA Regulatory Expert Present Episode 2, AscellaHealth Educational Webinars | Business & Finance | manchestertimes.com | Business Wire | 7/14/2020

… Revolution: How the Rise of Specialty Pharmacy Drove a New PBM Model” focuses upon cost-curbing solutions related to specialty pharmacy benefit management (PBM) and medical infusion carve-out models. This press release features multimedia … concerns about their extraordinary high cost and overall effectiveness,” says Dea Belazi, president and CEO, AscellaHealth. “We’ve attracted leading industry experts to this webinar to demonstrate that saving opportunities still exist with generics and biosimilar …

George D. Yancopoulos

Regeneron Announces Start of REGN-COV2 Phase 3 COVID-19 Prevention Trial in Collaboration with National Institute of Allergy and Infectious Diseases (NIAID) | PR Newswire | 7/6/2020

… a potential solution to prevent and treat COVID-19 infections, even in the midst of an ongoing global pandemic,” said George D. Yancopoulos, M.D., Ph.D., Co-Founder, President and Chief Scientific Officer of Regeneron. “We … including private payer healthcare and insurance programs, health maintenance organizations, pharmacy benefit management companies, and government programs such as Medicare and Medicaid; coverage and reimbursement determinations by such payers and new policies and procedures adopted …

Greg Watanabe

AllazoHealth names pharmacy benefits management leader Greg Watanabe to advisory board | PRWeb | 6/1/2020

AllazoHealth names pharmacy benefits management leader Greg Watanabe to advisory board Share Article AllazoHealth, a company that uses artificial intelligence to help pharmaceuticals, payers, and pharmacies improve medication adherence and quality outcomes, announced today that pharmacy benefits management executive Greg Watanabe will be joining the company’s Advisory Board. “Greg is an outstanding senior executive who brings deep expertise in pharmacy benefits management that will contribute to our company’s continuing growth …

Israel Lowy

Regeneron Presentations at ASCO 2020 Showcase Diverse Clinical Oncology Portfolio | PR Newswire | 5/14/2020

… program to potentially transform treatment paradigms across multiple solid tumors and blood cancers where there are significant unmet needs,” said Israel Lowy , M.D., Senior Vice President, Translational and Clinical Sciences, Oncology at Regeneron. “We’ve already … including private payer healthcare and insurance programs, health maintenance organizations, pharmacy benefit management companies, and government programs such as Medicare and Medicaid; coverage and reimbursement determinations by such payers and new policies and procedures adopted …

Susan A. Cantrell

AMCP and AMCP Foundation Announce 2020 Award Winners in Managed Care Pharmacy | PR Newswire | 5/12/2020

… spring. www.amcp.org/amcp-foundation “I offer my deepest congratulations to the outstanding AMCP and AMCP Foundation awardees,” says AMCP CEO Susan A. Cantrell , RPh, CAE. “Each one personifies the enduring commitment of our profession to … 300 million Americans served by private and public health plans, pharmacy benefit management firms, and emerging care models. Visit www.amcp.org . About AMCP Foundation Established in 1990, the 501(c)3 nonprofit AMCP Foundation is the …

Paige Minemyer

CVS is adapting its strategy for specialty pharmacy for COVID-19. Here’s how | FierceHealthcare | 5/8/2020

CVS is adapting its strategy for specialty pharmacy for COVID-19. Here’s how by Paige Minemyer May 8, 2020 2:09pm CVS Caremark has had to adapt its specialty pharmacy programs to the challenges of COVID … and investments we’ve made in the company, specifically in the [pharmacy benefit management (PBM)] and specialty pharmacy range, have really started to resonate and create really good use cases during this pandemic,” he told FierceHealthcare …

John Reed

Phase 3 Trial of Libtayo® (cemiplimab) as Monotherapy for First-Line Advanced Non-small Cell Lung Cancer Stopped Early Due to Highly Significant Improvement in Overall Survival | PR Newswire | 4/27/2020

… positive results are extremely encouraging, and we look forward to advancing a potential new treatment option for these patients,” said John Reed , M.D., Ph.D., Global Head of Research and Development at Sanofi. “We are grateful … including private payer healthcare and insurance programs, health maintenance organizations, pharmacy benefit management companies, and government programs such as Medicare and Medicaid; coverage and reimbursement determinations by such payers and new policies and procedures adopted …

Glen Stettin

Americans Are Taking 34 Percent More Anxiety Meds Since Coronavirus Pandemic Started, Study Says | Newsweek | 4/2/2020

pharmacy benefit management company Express Scripts released on Thursday. The report found that use of benzodiazepine anti-anxiety medications peaked on the week ending March 15, spiking by almost 18 percent. “It’s hard to imagine we don’t have a lot of our fellow Americans under incredible stress right now, either from getting sick or being afraid of being sick or losing their jobs,” Dr. Glen Stettin, Senior Vice President and …

Michael Perry

BenePrecise, BeneCard PBF’s Cutting-Edge Pharmacogenetics Program, Recognized with PBMI Excellence Award | PR Newswire | 3/10/2020

PRNewswire/ – BeneCard PBF, a pharmacogenetics leader in the PBM industry, has received the Pharmacy Benefit Management Institute’s (PBMI) Excellence Award for Care Management Strategies. PBMI presented the award in acknowledgment of the critical improvements to … to improve the entire patient experience,” says BeneCard PBF president Michael Perry . “BenePrecise facilitates unmatched hands-on care coordination, which is a key component of safeguarding members’ health and delivering genuinely personalized care.” BenePrecise revolutionizes …

Michael F. Neidorff

Centene and CVS Health Announce Agreement for CVS Health to Acquire IlliniCare Health | PR Newswire | 12/2/2019

… a smooth transition for members. “We are continuing to make progress towards completing our transaction with WellCare and the divestiture of our IlliniCare Health plan is the next step in that process,” said Michael F. Neidorff , Centene’s Chairman, President and Chief Executive Officer. “Our employees in Illinois have done an exceptional job serving our communities in the state. We are pleased to enter this agreement with CVS Health, under which …

Patrick Graham

Wall Street near highs after upbeat earnings run | Yahoo News | 11/6/2019

… gained 2.6% in premarket trading after the pharmacy chain posted a better-than-expected quarterly profit, partly boosted by its pharmacy benefit management unit. But shares of Match Group Inc MTCH.O fell 10.4% after the … down 3.1%. (Reporting by Arjun Panchadar in Bengaluru; editing by Patrick Graham

Quincy Krosby

US STOCKS-Wall St little changed but report trade deal could be delayed weighs | Yahoo News | 11/6/2019

… highs. The year end is typically a bullish time for stocks, but the trade war is still a risk, said Quincy Krosby, chief market strategist at Prudential Financial in Newark, New Jersey. Also, “there’s been … quarterly profit, boosted by its Aetna health insurance business and pharmacy benefit management unit. The Dow Jones Industrial Average fell 2.91 points, or 0.01%, to 27,489.72, the S&P 500 lost 0.21 points, or 0.01 …

Caroline Valetkevitch

US STOCKS-Wall St ends near flat; healthcare shares gain but trade deal delay weighs | Yahoo News | 11/6/2019

… flat, S&P 500 up 0.1%, Nasdaq down 0.3% (New throughout, updates prices, market activity and comments to close) By Caroline Valetkevitch NEW YORK, Nov 6 (Reuters) - U.S. stocks ended little changed on Wednesday as … quarterly profit, boosted by its Aetna health insurance business and pharmacy benefit management unit. The S&P health care was up 0.6%. The Dow Jones Industrial Average fell 0.07 points to 27,492.56, the S&P …

Michael Nagle

Stocks making biggest moves midday: HP, Uber, Coty, CVS, Altice USA | CNBC | 11/6/2019

… IPO) on the floor of the New York Stock Exchange (NYSE) in New York, U.S., on Friday, May 10, 2019. Michael Nagle Bloomberg Getty Images Check out the companies making headlines in midday trading: HP … analyst estimates. Results were helped by strength in the company’s pharmacy benefit management unit, as well as its Aetna health insurance business. Altice USA – Shares of Altice USA tanked 17.1% on disappointing quarterly results and …

Stefano Pessina

Walgreens Partners With Centene And AdvanceRx On Cloud PBM Deal | Forbes | 10/17/2019

… IngenioRx. “Collaboration between retail pharmacies and payers like Centene can further transform the way we provide care,” said Walgreens CEO Stefano Pessina. “Using RxAdvance’s collaborative PBM cloud, our partnership can empower our pharmacists to make … to the buyer. “Centene is committed to supporting a transparent pharmacy benefit management model that is sustainable with higher quality care for members at a lower cost to our customers,” Centene chairman and CEO Michael …

David Wichmann

UnitedHealth Group posts $5B in Q3 profit, boosted by double-digit growth rates at Optum | FierceHealthcare | 10/15/2019

… David Wichmann, CEO of UnitedHealth Group, in the earnings release. RELATED: UnitedHealthcare ramping up investment in virtual visits, home monitoring for 6M Medicare Advantage members Optum posted double-digit growth in both revenue and earnings for the quarter, UnitedHealth announced. The company, which offers a diverse array of services including pharmacy benefit management and provider services, saw its revenue increase by 13% year over year to $28.8 billion and earnings …

Tom Murphy

UnitedHealth revenue up 7%, raises annual outlook - The Morning Call | Chicago Tribune | 10/15/2019

… billion, also fueled by an expansion of behavioral health services. UnitedHealth’s Optum segment also runs one of the nation’s largest pharmacy benefit management businesses and provides other services. Operating earnings from Optum jumped 20% in … coverage and as Congressional committees investigated soaring drug costs. ___ Follow Tom Murphy on Twitter: @thpmurphy …

Laura Wood

Outlook on the World Pharmacy Automation Market, 2024 - Leading Companies are Baxter International, Becton, Dickinson & Co, Cerner Corp, Omnicell, and Parata Systems | PR Newswire | 10/10/2019

… pharmacy automation Acute-care settings Long-term care settings Outpatient pharmacy automation Outpatient/fast-track clinical settings Hospital retail settings Pharmacy benefit management services and other mail-order settings Retail pharmacy chains Each segment is … focused, comprehensive and tailored research. Media Contact: Research and Markets Laura Wood , Senior Manager [email protected] For E.S.T Office Hours Call +1-917-300-0470 For U.S./CAN Toll Free Call +1-800-526-8630 For GMT Office Hours Call +353-1-416-8900 …

Mike Ellis

Maxor’s Chief Pharmacy Officer, Michael Einodshofer, Named 2019-2020 President-Elect of National Association of Specialty Pharmacy | PR Newswire | 9/11/2019

… Team at NASP 2019 (from left) Mike Einodshofer, Jessie Heaton, Bill Aikins, Nicole Shoquist, Ryan Atkinson, Suzanne Hansen, Mike McDonald, Mike Ellis Einodshofer has served on the NASP Board of Directors since 2017. He is … pharmacy industry to create healthier lives through purposeful engagement across Pharmacy Benefit Management, Pharmacy Management, Specialty Pharmacy, 340B , Rebate and Formulary Management, and Pharmacies. We put people first and are committed to providing outstanding service …

Derica Rice

New Offering from CVS Looks to Advance Pharmacy Benefit Management | HealthPayer Intelligence | 6/13/2019

Value-Based Care News New Offering from CVS Looks to Advance Pharmacy Benefit Management The Vendor Benefit Management service from CVS aims to reduce the burden of using third-party health and wellness solutions for … help improve health outcomes and reduce overall medical spend,” stated Derica Rice, president of CVS Caremark, the company’s PBM business. Dig Deeper CMS Addresses Prescription Drug Price Spreading Issues “We asked our clients what they …

Gail K. Boudreaux

Anthem, Inc. to Acquire Beacon Health Options | Business Wire | 6/6/2019

… as an innovative and valuable partner, we’re focused on providing solutions that address the needs of the whole person,” said Gail K. Boudreaux, President and CEO, Anthem. “With an extensive track record in behavioral health … and financial condition; non-compliance by any party with the pharmacy benefit management services agreements between us and each of Express Scripts, Inc., or Express Scripts, and CaremarkPCS Health, L.L.C., or CVS Health, as well …

Peter Lynch

These 3 High-Yield Blue Chips Are Very Strong Buys - Bristol-Myers Squibb Company (NYSE:BMY) | Seeking Alpha | 5/16/2019

… is likely much better. However, while deep value investing is potentially highly lucrative, it’s also easier said than done. As Peter Lynch, the second best investor in history behind Buffett (29% CAGR total returns from … itself to potentially greater regulatory risk) via a shift into pharmacy benefit management, long-term healthcare, and now health insurance. 2006’s $21 billion purchase of Caremark RX (which made it into one of America’s …

Mitch McConnell

Health care CEO: Medicare for all plan ‘would just collapse the system’ - AOL | Yahoo News | 5/11/2019

… Sens. Bernie Sanders (I-VT) and Kamala Harris (D-CA), have called for Medicare for all , while Republican politicians like Mitch McConnell are in favor of cutting health care spending. Medicare, along with Medicaid and … though they’re an attractive whipping boy, to go after them.” Pharmacy benefit management systems “have increased the cost savings by negotiating volume discounts,” Flanders said. “But, they also bring an additional layer of expense into …

Bernie Sanders

Health care CEO: Medicare for all plan ‘would just collapse the system’ - AOL | Yahoo News | 5/11/2019

… main point of contention as the U.S. gears up for the 2020 presidential election. Several Democratic presidential candidates, including Sens. Bernie Sanders (I-VT) and Kamala Harris (D-CA), have called for Medicare for all … though they’re an attractive whipping boy, to go after them.” Pharmacy benefit management systems “have increased the cost savings by negotiating volume discounts,” Flanders said. “But, they also bring an additional layer of expense into …