Resources

  • 18 Apr 2012

    New Control Techniques on the Horizon for Payer Oncology Management

    Lee Goldberg, Director, Syndicated Research, Zitter Health Insights

    Despite a consensus increase in management aggressiveness over the past two years, payers have not seen a corresponding rise in effectiveness, opening the door for new control techniques in the future management of oncology. Payer-reported levels of oncology management aggressiveness have increased substantially over the past two years. However, despite their expanded use of ASP […]

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  • 03 Apr 2012

    Cost-Sharing and PA Rates Differ between Medical and Pharmacy Benefit

    Lee Goldberg, Director, Syndicated Research, Zitter Health Insights

    Despite a plurality of payers reporting a disparity in cost-sharing levels and prior authorization rates for agents covered on the medical versus the pharmacy benefit, there is little attempt to reconcile the issue. Payers report that both prior authorization rates and cost-sharing amounts tend to be lower for medical benefit agents than for those agents […]

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  • 14 Feb 2012

    Cost Concerns Continue to Dominate Benefit Design

    Lee Goldberg, Director, Syndicated Research, Zitter Health Insights

    To combat rising costs, payers look to increase utilization management and raise member premiums. Employers shy away from restricting utilization, but are on board with shifting cost-share to employees. Both payers and employers report that total medical and pharmacy costs, as well as disease prevalence, primarily dictate which categories they rate as their highest priorities. […]

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