Insights

Original research, studies and thought leadership pieces relevant to the regulated markets business.

perspectives

Former Chief Economist for Health Committee Warns Against Government Intervention in Private Market

The Pharmaceutical Care Management Association (PCMA) shared a blog from former policy director and chief economist for the U.S. House Committee on Ways and Means Alex Brill, where he warns Congress against misguided government interventions in the private health care market that would boost Pharma’s profits and hike health care costs for everyone else. He […]
read more >

February 11, 2025

EGWP marketplace medicaid Medicare

perspectives

CSRxP Highlights 2025 Drug Price Hikes Outpacing Inflation

The Campaign for Sustainable Rx Pricing (CSRxP) highlighted that drug manufacturers have continued with their annual drug price increases, even as policymakers debate ways to lower drug costs for patients. In the first week of January, brand drug manufacturers raised prices on more than 250 drugs, with more increases expected throughout the month. The average […]
read more >

February 11, 2025

EGWP marketplace medicaid Medicare

survey results

HHS OIG Report Finds Half of Hospitals Fail to Comply with Transparency Law

A new report by HHS’s Office of Inspector General (OIG) finds widespread failure among hospitals to comply with federal price transparency law, with almost half of 100 surveyed hospitals not fully compliant. The report found that many hospitals are not publishing their prices in accordance with the law, with some hospitals saying they would rather […]
read more >

December 10, 2024

medicaid Medicare

survey results

AHIP Releases Nationwide Poll Showing Strong Satisfaction with Employer-Provided Coverage

AHIP’s Coverage@Work released the results of a new nationwide poll that found strong satisfaction with employer-provided coverage. A growing majority of consumers (75%, up 12% since April 2023) are satisfied with their current employer-provided coverage and 74% prefer to get their coverage through their employer. Plan satisfaction is driven by the comprehensive coverage (49%), affordability […]
read more >

December 10, 2024

marketplace

survey results

Lown Institute Study Finds Unnecessary Back Surgeries Cost Medicare $600 Million Annually

A new analysis from the Lown Institute, an independent think tank, found that hospitals performed more than 200,000 unnecessary back surgeries on Medicare beneficiaries in the U.S. over three years. Roughly $2 billion was spent on the “low value” procedures while patients were put at risk of poor outcomes, researchers wrote. The researchers looked at […]
read more >

December 10, 2024

EGWP Medicare

Solutions

Medicare Prescription Payment Plan (M3P) Educational Overview

With Open Enrollment right around the corner, Medicare eligible members can begin opting in to the Medicare Prescription Payment Plan (M3P). Discover more about the M3P program and how Express Scripts by Evernorth supports clients with a solution. Watch now: https://bit.ly/47yF5vf
read more >

October 8, 2024

Medicare

Solutions

Learn how Express Scripts by Evernorth can help plans succeed in the complex world of government-regulated health care

The world of Regulated Markets is constantly changing. Express Scripts by Evernorth offers the expanded capabilities you need to succeed in today’s regulated space by turning insightful data into innovative solutions that drive affordability and opportunities for better member outcomes. Watch now: https://bit.ly/3swVK23
read more >

October 8, 2024

marketplace medicaid Medicare

Guidance

Inflation Reduction Act (IRA) Educational Resources

As a means of providing additional support to our clients, the following videos and companion guides have been created to provide education and awareness to agent/brokers and customer service. This content is designed to be an educational resource for these key stakeholders to highlight recent and upcoming changes to the Medicare Part D program. This […]
read more >

August 21, 2024

Medicare

perspectives

What impact will the Inflation Reduction Act have on health plans?

Plan sponsors should be aware of the effects the law will have on Medicare Part D over the coming years.
read more >

March 6, 2024

EGWP marketplace medicaid Medicare