The Affordable Care Act (ACA) introduced Medical Loss Ratio (MLR) requirements for fully insured medical plans. These rules require insurers to spend a substantial portion of premium dollars on actual health care services and quality improvements. In turn, they limit the dollars that can go toward administrative costs like marketing, salaries, agent commissions, and profits. The MLR ...
Amid pressure from the White House, U.S. drug companies are experimenting with direct-to-consumer sales models that cut out the middlemen.
The partnership between GoodRx and Novo Nordisk represents a seismic shift in the diabetes drug sector, redefining pricing power and market access for GLP-1 receptor agonists (GLP-1RAs). By slashing the cash price of Ozempic and Wegovy to $499 per month for self-paying patients, the collaboration not only addresses affordability gaps but also positions both firms ...
President Trump on Wednesday ordered his health officials to secure a six-month supply of advanced pharmaceutical ingredients for drugs the administration determines are critical for national health and security. Why it matters: The move continues efforts started during the Biden administration to reshore the medical supply chain and reduce the reliance on overseas manufacturers, especially China. The government ...
As small businesses navigate an uncertain economic environment, many are still looking to expand or maintain their health benefit offerings, according to a new report from Chase. The report surveyed 563 small business owners in June for the annual midyear check-in on their business and found that 80% currently offer health coverage for their employees, with half ...
Employers have been asking health insurers for years to speed up and simplify efforts to screen workers’ requests for coverage for CAT scans, specialty drugs and stomach operations. Insurers told state insurance regulators Tuesday that, this time around, they think they really can make prior authorization processes work better. New data standards and new artificial ...