Views: Is reference-based pricing driving the recent spate of healthcare acquisitions?

Employee Benefit Advisor

Is ubiquitous ‘in-network’ health plan model on the way out? As more employers drop their fully-insured health plans in favor of self-funding and reference-based pricing strategies that could be the case.

The insurance network has long been the cornerstone of many insurance carriers’ value propositions. But reference-based pricing plans do not make use of network contracts, and many self-funded plans see less value in obtaining these agreements.

Without a network to fall back on, the country’s leading health insurers will be on more level footing with third-party administrators for self-insured and reference-based pricing plans. That has prompted some carriers to take steps to diversify their service lines, leading them to acquire physician networks and other healthcare providers.

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CVS Looks to Carve Out More Healthcare Delivery Space

WOONSOCKET, R.I., Dec. 18, 2013 /PRNewswire/ — At its annual Analyst Day in New York City today, CVS Caremark (NYSE: CVS) outlined its strategies to drive long-term enterprise growth.

“CVS Caremark has an in-depth understanding of the changing health care landscape, including the challenges and opportunities that lie ahead,” said Larry J. Merlo, president and chief executive officer of CVS Caremark.  “These changes in the environment are creating opportunities for the company, and our unique combination of ability and agility positions us to capitalize on these opportunities – however they take shape.” Continue reading

Humana and CVS Announce Strategic Retail Partnership

LOUISVILLE, Ky. & WOONSOCKET, R.I.–(BUSINESS WIRE)–Humana Inc. and CVS/pharmacy have announced a strategic retail partnership designed to educate individuals and their families about their health care coverage options under the Affordable Care Act (ACA).

Humana representatives will be present at CVS/pharmacy’s Project Health events starting this month. Humana will also be holding in-store events at CVS/pharmacy locations to educate individuals and their families about health care coverage options under the ACA.

Humana and CVS/pharmacy will also provide educational brochures and other materials that will be available to individuals and their families.

See the full story at Humana.com.

Healthcare Reform Heats up Drugstore Battle

The healthcare reform law will expand access to medical services for millions of people. That’s going to place added pressure on primary healthcare providers and challenge the system to meet the new demand.

So it may not be surprising that the nation’s three major drugstore chains are gearing up to play a bigger role. They’re placing retail health clinics in their stores, pushing their pharmacists to be more proactive with their prescription customers, and even entering partnerships with big medical groups.

See the full story at LATimes.com

 


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