Cigna Focuses On Its Services Entity’s Growth
Cigna CEO David Cordani has sent a strong message that Cigna’s focus is on Evernorth, its services entity. Cordani says its pharmacy benefits manager (PBM), Express Scripts, and specialty pharmacy are strong focuses moving forward. They are both housed in Evernorth.
The attention makes sense. Evernorth has grown tremendously and has been a huge contributor to margin. The attention to drug costs, including creative ways to address the growth of weight-loss drugs and transitioning to biosimilars, is important.
At the same time, Cigna will see continued political pressure on the market size of its PBM. PBM reform legislation is becoming more and more likley this year. Cigna seems to think the rise of transparency will not disrupt Express Scripts placement in the market right now.
Additional article: https://www.beckerspayer.com/payer/cigna-ceo-expect-choppiness-in-glp-1-coverage.html
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#cigna #pbms #drugpricing #biosimilars #weightlossdrugs
Centene Continues To Have Medicaid Pressures
Centene announced its business is still being impacted by the reintroduction of Medicaid redeterminations. In addition, Centene will exit six states in Medicare Advantage (MA). It stock dropped on the news about Medicaid.
Additional article: https://www.medicaremarketinsights.com/p/wellcare-exiting-ma-6-states-heres-opportunity
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#centene #medicaid #managedcare #medicareadavantage
Harris Would Push Antitrust Agenda; Trump May Too
Interesting article on what could happen with Biden’s antitrust agenda with the change in the White House. Harris would definitely continue efforts, perhaps more aggressively. Trump may also be tougher than he was due to VP nominee JD Vance’s views.
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#antitrust #manda #mergers #acquisitions #election2024
340B Getting Contentious In State Courts
States are increasingly passing laws to stop drug companies’ efforts to rein in how providers dispense drugs furnished under the 340B program. Drug companies argue that states are pre-empted from passing restrictions on a federal program. Providers argue that drug companies are putting unreasonable restrictions on the program meant to ensure access to drugs for those of low income.
I am no fan of the brand drug makers, but I do believe that providers are abusing the program and often pad their margins by accessing drugs at the low program costs while not fulfilling 340B’s intent. Drug makers are likely correct that pre-emption applies here.
(Article may require a subscription.)
#340b #drugpricing
Largest Increases and Decreases In Exchange Premiums For 2025
Exchange premiums are expected to increase on average next year considerably. Using a Peterson-Kaiser Family Foundation (KFF) analysis, Becker’s has put together a list of plans with the biggest premium reductions and increases. In 2025, 324 insurers are offering ACA coverage across all 50 states and Washington, D.C. The median proposed premium increase is 7%.
Additional article: https://www.beckerspayer.com/payer/50-payers-lowering-aca-premiums-in-2025.html
#aca #obamacare #exchanges
https://www.beckerspayer.com/payer/20-payers-raising-aca-premiums-the-most-in-2025.html
Elevance To Expand In Marketplace Exchanges
Elevance Health announced the company is debuting individual marketplace plans in Florida, Maryland and Texas. The plans begin in 2025.
#elevancehealth #aca #obamacare #exchanges
https://www.fiercehealthcare.com/payers/elevance-health-adds-aca-plans-florida-maryland-texas
Consumer Survey Shows What Is Important To MA Enrollees
A good article on a recent survey showing what is important to Medicare Advantage (MA) enrollees. The key factors for satisfaction are:
- Responsiveness
- Education
- Simplicity
- Strong Benefits
- Consistency
Let’s see how this jives with 2025 benefits. We know consistency and strong benefits could be hurt by cutbacks next year.
#medicareadvantage #enrollment #marketing
— Marc S. Ryan
