Pharmacy Benefits Management companies (PBMs)

> Hospitals in Pennsylvania, including the University of Pittsburgh Medical Center network, are providing more uncompensated care than last year, a local industry trade group reports. Article

> Blue Cross of Massachusetts will double the amount it spends on pay for performance programs--with spending rising to $189 million in the state. …

Today's earnings announcements from health plans and insurers don't look too bad. WellPoint reported a 20 percent surge in profits yesterday, a gain that the company attributes to an increase in membership and decreased medical costs. Aetna also posted good earnings, with first quarter profits up 3.2 percent, but reported a first quarter medical cost ratio of 79.4 percent in its main commercial business. That was up from 77.9 percent a year earlier. Meanwhile, PBM Express Scripts had …

> The Tenet Shareholder's Committee emailed evidence that suggests that Louisiana AG Charles Foti's investigation of the company's role in the deaths at Memorial Medical Center is still ongoing. Blog

> Colorado lawmakers rejected a law that would have required PBMs to open their books and disclose ownership interests. …

After years of excellent numbers, some critics are starting to wonder if things are about to take a turn for the worse at UnitedHealth. Goldman Sachs analyst Matthew Borsch reiterated his underperform rating for the company this weekend. Borsch says problems at recently acquired PacifiCare, "market noise on deteriorating customer service" and questions about corporate governance are "red flags" that should not be taken lightly. Borsch notes that PacifiCare earnings in California have …

More encouraging news about ePrescribing this morning as the Henry Ford Health System (and its subsidiary Health Alliance Plan) is trumpeting its successful implementation of a system backed by PBM giant Medco and the big auto makers. As expected, ePrescribing reduces medical errors and increases the use of generics (and hence lowers drug costs for payers). That's why ePrescribing is …

This week the most convoluted program in the history of Medicare began. I've heard comments from friends, neighbors and people in the press saying that they can't make heads or tails of the new drug benefit.

Whether you like it or loathe it, there are some interesting parts of the Medicare Modernization Act, including the HSA provision and the disease management provisions. …

Shares of the big three pharmacy benefits management (PBM) companies--Medco, Express Scripts and Caremark--were all lower this morning after a federal appeals court upheld a Maine law that forces PBMs to reveal information about their business dealings with drug companies. PBMs receive rebates from drug companies for guaranteeing position of brand-name drugs on their formularies, and this practice has been very controversial. The law also requires PBMs to act in the best interest of their …

These appear to be halcyon days for the big PBMs. Their various mergers and IPOs are completed, there are more and more drugs coming off patents enabling them to save more money by using generics and the Medicare Part D drug coverage gives them a whole new market among seniors. By yesterday, the share prices of the big three--Medco, Caremark and Express Scripts--were up more than 50 percent for the year so far, with Express Scripts stock up more than 150 percent.

But today Medco …

Pharmacy benefits manager Express Scripts released a report today which argues that the healthcare system could save $20 billion if healthcare providers switched to commonly available generic drugs instead of using more expensive brand name medicines. The company's Generic Drug Usage Report looks at costs for about 3 million people participating in its network across six drug classes, including NSAIDS, cholesterol fighting statins, GI drugs and antidepressants. Express Scripts estimates …

The growth (or lack of growth) in consumer involvement in electronic health records remained a key topic at the AHIMA meeting in San Diego. The Markle Foundation's Carol Diamond and the Health Privacy Project's Emily Stewart both stressed that, despite latent consumer demand for EMRs, they will only get on board if they are convinced that their privacy is protected. Consumers are especially wary of both health plans and employers misusing their information. Scott Wallace, from the …