So let’s get down to what’s really happening here. Once upon a time the PBM models were a different type of creature but as time moved on they became less about a better and affordable price for prescriptions and more about and algorithmic machine to create …
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Medically Related
Optum certainly kept this very quiet when they sold their hospice facilities to Compassus and I don’t think they even told their own investors. I could not locate any SEC 10k filings or even a Form D from a search I did and this sale took place a year ago. …
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This is a video of a recent presentation I did at the 74th Annual AAPS (American Association of Physicians and Surgeons) meeting. I don’t do too much blogging anymore as I don’t want to be confused with all the “junk” news out there but thought this is worth…
Continue ReadingThis should not really come as a big surprise as what hasn’t the pharmacy benefit managment business touched? So what is Patients Who Pay “Cash” When Filling Prescriptions Are Now Called “outliers, Pharmacists Required to Fix outliers as They Show Up As Non …
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With prediction tools and apps being all the rage today, their reliability and accuracy are not always there. Before the word “prediction” took over, we used to have words like “trending” and number crunches used for a lot of what we saw, but today it’s the …
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Here we go again, back to those Ingenix algorithms and business models, getting a rerun of sorts of what occurred in 2011. In 2011 there was one main lawsuit from the AMA along with many others that were filed (some being still settled) over using formulas t…
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This is a pretty interesting lawsuit and it includes named invidituals at HHS and CMS as well as participants. You can view all the defendants included in the Walgreens Signs Agreement With PBM OptumRX (United Heatlhcare) and Anthem Then Sues Express Scripts…
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Here we go again. If you haven’t figured this out yet, when you buy a Cigna Health insurance policy you get a two for one with 2 insurers. Cigna provides the insurance benefits and then it’s pharmacy benefit manager, PBM OptumRX (biggest revenue sector subs…
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If you don’t know what a Quant is, take time out and watch video #2 in the footer of this blog as they are not just limited to working at financial firms. As a matter of fact, hedge funds and banks can’t hire enough of the and the same holds true for insurer…
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