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Weekly Digest

This Week

Jan 28, 2023

Amazon Pharmacy rolls out service for unlimited generic drug prescriptions for $5 a month

Medicare Advantage plans brace for final controversial risk adjustment rule by Feb. 1

Dollar General pilots mobile clinics as it targets a bigger presence in healthcare - Robert King

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Amazon Pharmacy rolls out service for unlimited generic drug prescriptions for $5 a month

By Heather Landi

Amazon's pharmacy business is rolling out a new subscription service that enables Prime members to get unlimited generic medications for a flat fee of $5 a month.

Medicare Advantage plans brace for final controversial risk adjustment rule by Feb. 1

By Robert King

Medicare Advantage plans are bracing for a final risk adjustment rule expected next week that could put them on the hook for overpayments dating all the way back to 2011.

Dollar General pilots mobile clinics as it targets a bigger presence in healthcare

By Heather Landi

Discount retailer Dollar General is expanding into healthcare services in what could be a competitive shot across the bow for drugstores. The company is piloting mobile health clinics at three stores in Tennessee to provide customers with basic, preventive and urgent care services along with lab testing.

Managed care plans, states can now text Medicaid beneficiaries to warn of enrollment changes

By Robert King

New FCC guidance allows states and managed care plans to text Medicaid beneficiaries on potential changes to their coverage.

Medicare officials call for gradual shift in calculation of Medicare Advantage benchmarks to reflect growing popularity

By Robert King

Biden administration officials said that Medicare Advantage will need to gradually shift toward administrative benchmarks to set payment rates as the program's popularity explodes.

Elevance Health to acquire Blue Cross and Blue Shield of Louisiana

By Paige Minemyer

Elevance Health has inked a deal to acquire Blue Cross and Blue Shield of Louisiana, with the Pelican State insurer joining the Anthem Blue Cross affiliated plans.

How Amazon's latest pharmacy move lays the groundwork for longer-term play

By Heather Landi

Amazon Pharmacy's RxPass subscription program is not breaking new ground or particularly disruptive to the pharmacy market in the near term. But industry experts say the move is worth watching for how it lays the groundwork for the e-commerce giant's long-term healthcare and pharmacy strategy.

Wave of leading medical schools pull out of U.S. News' annual rankings

By Dave Muoio

Deans from the medical schools at Harvard, Columbia, Stanford, UPenn and Mount Sinai said in announcements that the publication's rankings "create perverse incentives" for higher learning institutions.

CMMI Director Liz Fowler: Expect advance primary care, total cost models to be released in 2023

By Robert King

CMMI aims to release three to four new advance primary care payment models this year and another model enabling states to oversee the total cost of care for Medicare beneficiaries, Director Liz Fowler shared.

Optum rolls out new tool that automatically offers members the lowest generic price

By Paige Minemyer

Optum Rx is launching a new tool that aims to make it easier to compare the direct-to-consumer price for generic drugs to the price with insurance.

Fierce podcasts

Don't miss an episode

'Podnosis': Fierce's JPM Week panel about big retailers reshaping primary care and Ramita Tandon on Walgreens' drug research plans

In this week's episode of "Podnosis," we take you inside Fierce's JPM Week event. Listen in on snippets from a panel on what big retailers have to gain by moving into healthcare. And hear from Ramita Tandon about Walgreens' strategy around drug development.

'Podnosis': Fierce 15 honorees and how to prevent the disruption of cancer care in times of crisis

'The Top Line': What the pharma industry can expect with the new Inflation Reduction Act, and biotech's outlook for 2023

Resources

Whitepaper

Improve the Mental Health Patient Experience with Revenue Cycle Management Technology

Resolving billing errors and resubmitting claims can be a time-consuming, process rife with hidden costs, straining the billing department and negatively impacting revenue.

The Change Healthcare 2022 Revenue Cycle Denials Index

The Change Healthcare 2022 Revenue Cycle Denials Index provides a review of national medical claim denial trends, with strategies to help decrease denial rates.

Humanizing Revenue Cycle Management

See how over 90% of healthcare organizations have seen improvements to business-critical metrics after working to make RCM more patient-focused

Generate ROI Through Integrated Medicare Advantage SDoH Advocacy

Do SDoH strategies actually work, and what is the potential return on investment should your organization decide to implement one?

Interoperability: Why It’s Critical to Health Plans

NTT DATA and HFS Research paper on digital transformation and interoperability.

The Business Case for Digital Health: Chronic care solutions to cut costs and improve member outcomes

Payers have the power to significantly cut costs and reduce the need for serious medical interventions among members by supplementing the time they spend away from their doctor’s office with integrated digital health solutions caring for multiple chronic conditions.