Wednesday, January 16, 2019

Hump day update

Healthcare Dive identifies watchable 2019 healthcare industry trends for payers and providers.  The number one trend for payers is contentious negotiations and contract disputes with participating providers.

In this regard --
  • The Wall Street Journal reports on contentious negotiations between prescription benefit manager CVS Caremark and Walmart.  Walmart could leave the CVS Caremark employer sponsored plan networks but plans to remain in the CVS Caremark Medicare Advantage 
"Walmart is one of the country’s largest retail pharmacy players, offering pharmacies in nearly all of its approximately 4,600 U.S. stores. CVS said it retains a large network of more than 63,000 pharmacies without Walmart, and less than 5% of its members enrolled in affected plans use only Walmart for prescriptions.But the impact could be heavier for the employees of clients in rural areas and the South, where Walmart is a particularly important presence, said Nadina Rosier, who is head of the pharmacy practice at advisory firm Willis Towers Watson. “It truly depends on your vantage point,” she said.  'If you’re  a member who works for an employer where Walmart is the dominant player, you’re going to feel the pain.'”
This story will be fast moving.
  • On the flip side, Tenet Healthcare, a large nationwide provider, announced deals with payers Anthem and Humana according to Modern Healthcare
CNBC reports on a seven year contract between the Walgreen's pharmacy chain and Microsoft. This announcement follows up on last week's disclosure of a deal between Walgreen's and Alphabet's life sciences unit, Verily. The article suggests that these deals are defensive plays by healthcare providers and technology companies to be positioned to compete against Amazon.
 


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