Posts Tagged ‘pharmacies’

Healthcare Business Week in Review: Insurance Deadline Extension; Specialty Pharmacies; Care Transitions

July 9th, 2013 by Cheryl Miller

Employers will have more time to comply with the ACA mandate on insurance coverage, according to a White House blog posted by Valerie Jarrett, senior advisor and assistant to the president for Intergovernmental Affairs and Public Engagement.

In response to concern from employers with more than 50 employees working more than 30 hours a week that they would not have enough time to comply with the ruling by 2014, the administration has extended it by a year, and will simplify the reporting process. Plans to open health insurance exchanges on October 1 are still going forward, the administration says. More details can be found inside.

Kidney transplant patients who use specialty pharmacies as opposed to retail pharmacies report lower healthcare costs, according to a study published in the Journal of Managed Care Pharmacy.

The one-year study conducted by Optum found that those transplant patients using individualized services provided by the pharmacies, including adherence and clinical management programs, member education, and counseling services provided by pharmacists trained in transplant pharmacology, showed 30 percent lower post-transplant-related medical costs and 13 percent lower overall healthcare costs.

Medication adherence is one area of transplant medicine that needs improvement, researchers state. While the rate of non-adherence is highest at one to three years post-transplant, it may happen at any point during lifelong therapy.

Personal time and contact with patients during care transitions — before and after their hospital discharge — significantly reduces readmission rates, according to a study conducted by the Bronx Collaborative, a group of hospitals and health insurers in the Bronx, N.Y.

Among 500 patients who received two or more of four interventions by nurse care transition managers in a special program to manage the transition between hospital and home, only 17.6 percent were readmitted to the hospital within 60 days of discharge versus 26.3 percent among a comparison group of 190 patients who received the current standard of care, the data showed.

Another 85 patients who received only one intervention for a variety of reasons had an overall readmission rate of 22.8 percent. More inside on the four interventions.

And, if you have the time, please take our latest 10 question survey on Managing the Dually Eligible. Tell us how you’re managing this population, which constitutes about 9 million individuals who are eligible for both Medicaid and Medicare in the United States, and receive a free executive summary of the compiled results. Your responses will be kept strictly confidential.

Medicare Aims to Improve User Experience

September 7th, 2012 by Cheryl Miller

Medicare user

Two new initiatives designed to help Medicare beneficiaries better understand their benefits are now available.

CMS has redesigned its Medicare Web site,, in an attempt to simplify the language and home page layout and make the content more accessible and quicker to navigate for Medicare beneficiaries, families and caregivers.

Users can now do the following directly from the home page:

  • Search for whether a specific test, item, or service is covered under original Medicare;
  • Get customized information based on a beneficiary’s specific situation;
  • Get quick links to replace a lost Medicare card, find a Medicare Advantage or prescription drug plan, and get help with healthcare costs.

And HHS has partnered with five major pharmacies to make educational materials on Medicare benefits more widely available, including information on newly available preventive services, and savings on prescription drug spending in the “donut hole” coverage gap.

Some examples of how the pharmacy partners, which include CVS Caremark, Walgreens, Thrifty White, Walmart, and Sam’s Club, will work together to increase awareness include the following:

  • CVS Caremark will distribute material to beneficiaries at its more than 7,300 CVS/pharmacy stores and 600 MinuteClinic locations, through brochures, register receipt messages and online;
  • Thrifty White pharmacy will provide information through its 85 locations throughout the midwest;
  • Walgreens will distribute information in nearly 8,000 pharmacies and over 350 Take Care Clinic locations, as well as use in-store announcements;
  • HHS will also work with Walmart and Sam’s Club to provide healthcare information to their shoppers online.

Other pharmacies or partners can find information on how to work with CMS to educate consumers about the benefits available to them, while interested users can visit the new Medicare benefits site.