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BLOG: ‘Bundling’ Payments to Assure Appropriate Rx Use
Posted by
Dr. Richard Stefanacci on 8月 6, 20218/6/21
In Medicare’s drive to improve outcomes of the fee-for-service (FFS) payment model, this model is being replaced with value-based care. The delivery of value-based care is not supported by FFS payments, which incentivize the volume of…
BLOG: Pharmaceutical Value-based Contracts: Adherence and Supportive Contracts
Posted by
Dr. Richard Stefanacci on 7月 20, 20217/20/21
While there is a great deal of talk regarding value-based contracts in the life sciences industry, there are few successful examples. The difficulties in structuring these contracts begin with identification of outcomes that are directly and…
The Patient Access Paradox: How the New CMS Rule Could Prioritize Drug Pricing Before Clinical Decision-Making
In January 2023, co-pay programs will be put to the test, consequently examining how well your brand can adapt to the Final Rule changes to meet patient and provider needs. Our recommendation: Don’t wait – start…
BLOG: Medical vs. Pharmacy Benefit: A Look at UM Differences
Posted by
Dr. Richard Stefanacci on 7月 1, 20217/1/21
Medicare medical and pharmacy benefits are very different in their utilization management (UM). As such, it is valuable to know the distinctions between benefits, as strategies differ depending on which ones apply. The most significant differentiator…
Webinar: Medicaid & Government Pricing Congress
In this Medicaid & Government Pricing Congress panel, EVERSANA’s Mike Kurland, Vice President, Revenue Management and Compliance Solutions, discusses upcoming regulatory changes impacting government pricing and how to manage challenging reporting issues with calculation. How to…
Navigating Payer Formularies and Meeting Payer Needs — and Why It Matters
Posted by
Dr. Richard Stefanacci on 5月 21, 20215/21/21
In a market where all healthcare stakeholders expect more from manufacturers, payers are no exception. As payers work to support patients and meet their own industry needs, manufacturers need to understand payer processes to improve patient…
News Alert: MCIT Program Delayed Until December
The Centers for Medicare and Medicaid Services (CMS) again delayed implementation of the Medicare Coverage of Innovative Technology (MCIT) program, now until December 15, 2021. The program, as described in the current and preceding rules, will…
Gross-To-Net: Challenges and Best Practices
The application of clinical pathways and their enforcement through quality metric benchmark setting and appropriate use criteria is needed to guard against perverse financial incentives that encourage overutilization and underutilization. Moving forward, the more diligent payers…
The Secret’s Out: The Impact of Net Price Transparency
Pricing system pressures are increasing for the top four markets in Europe. Price transparency, changes to public health plans and curative therapies are set to disrupt traditional drug pricing. To navigate this ever-shifting landscape, companies must…
Ask the Expert: How to Maximize Your Omnichannel Strategy
Omnichannel strategies are transforming the way consumers interact with brands across industries – from the all-in-one Magic Band experience at Disney to buying your favorite latte with the Starbucks app. The pharmaceutical industry is no exception,…