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Industry Updates

This broad category includes articles concerning health insurance costs, carrier and health plan news, changing benefits technology, and surveys by the Kaiser Family Foundation and others on employee benefits.

Health Care Is Newsom’s Biggest Unfinished Project. Trump Complicates That Task

Six years after he entered office vowing to be California’s “health care governor,” Democrat Gavin Newsom has steered tens of billions in public funding to safety net services for the state’s neediest residents while engineering rules to make health care more accessible and affordable.

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Trump May Revisit Most Favored Nation Model for Prescription Drug Prices

Buried in the news from last month was an interesting nugget posted by Fierce Pharma: “Following a dinner at Trump’s Mar-a-Lago estate last week, Eli Lilly CEO David Ricks pointed to raising drug prices in other developed nations as a key strategy to reduce costs in the U.S.

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Drugmakers To Raise U.S. Prices On Over 250 Medicines Starting Jan. 1

Drugmakers plan to raise U.S. prices on at least 250 branded medications including Pfizer (PFE.N), opens new tab COVID-19 treatment Paxlovid, Bristol Myers Squibb’s (BMY.N), opens new tab cancer cell therapies and vaccines from France’s Sanofi (SASY.PA), opens new tab at the start of 2025, according to data analyzed by healthcare research firm 3 Axis Advisors. Nearly all of the drug ...

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Inflation And Family Caregiving Squeeze Retirement Plans

A number of different factors are putting stress on the finances of retired and pre-retiree Americans. According to a new report from the Society of Actuaries Research Institute, retirees are less likely to report being “better off than expected” in 2024 than in 2021. The study also shows that pre-retirees are more conscious of unplanned ...

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CVS Officially Rolls Out CostVantage Model For Commercial Prescriptions

All of the commercial prescriptions dispensed at CVS pharmacies will be processed through its CostVantage reimbursement model beginning this year, the healthcare giant announced Monday. Under the model, prescriptions are priced based on the underlying cost with a delineated markup and dispensing fee to cover the services provided by CVS in the transaction. The company says this ...

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Telehealth Gets Short Extension, Physician Pay Is Cut In Spending Bill

Stripped out of the final bill is a provision to prevent the 2.8% Medicare pay cut to physicians.

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Healthcare Execs More Optimistic Heading Into The New Year, Survey Finds

Even though there are still challenges facing the industry, healthcare executives are optimistic heading into 2025, with a new Deloitte survey showing 60% of C-suite leaders have a favorable view of the coming year, up from 52% a year ago. Most, 69%, expect greater revenues, while 71% anticipate improved profitability. After years of navigating their businesses through ...

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Hospitals Continue To Eat More Health Insurance Spending Pie

Private employers' expenditures are growing more than 70% faster than the national total, according to new government data.

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2025 Outlook: Employers Face Yet Another Year Of Healthcare Cost Increases

Employers are bracing for healthcare costs to spike yet again in 2025, and that’s likely to push firms to pursue significant changes, experts said. The Business Group on Health’s annual look at trends to watch notes that healthcare costs are set to increase next year by the largest margin in a decade. And a survey released in ...

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How a Duty To Spend Wisely on Worker Benefits Could Loosen PBMs’ Grip on Drug Prices

Ann Lewandowski knows all about pharmacy benefit managers, or PBMs, the companies that shape the U.S. drug market. Her job, as a policy advocate at drugmaker Johnson & Johnson, was to tell patient and physician groups about the PBMs’ role in high drug prices. Armed with that knowledge, Lewandowski filed a potentially groundbreaking lawsuit in ...

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