Pharmacy benefit managers were created as middlemen to reduce administrative costs for insurers, validate a patient’s eligibility, administer plan benefits, and negotiate costs between pharmacies and health plans. Over time, PBMs have been allowed to operate virtually unchecked. A lack of transparency in PBM practices has led several states to implement licensure/registration, fair pharmacy audit, or generic drug pricing legislation to try to level the playing field for pharmacies and patients. by the NCPA https://www.ncpanet.org/advocacy/state-advocacy/pbm-reform This Podcast is focusing on discussions & interviews about PBM Reform & those and Business of Pharmacy professionals leading this much needed reform.
All content for PBM Reform Podcast is the property of Pharmacy Podcast Network and is served directly from their servers
with no modification, redirects, or rehosting. The podcast is not affiliated with or endorsed by Podjoint in any way.
Pharmacy benefit managers were created as middlemen to reduce administrative costs for insurers, validate a patient’s eligibility, administer plan benefits, and negotiate costs between pharmacies and health plans. Over time, PBMs have been allowed to operate virtually unchecked. A lack of transparency in PBM practices has led several states to implement licensure/registration, fair pharmacy audit, or generic drug pricing legislation to try to level the playing field for pharmacies and patients. by the NCPA https://www.ncpanet.org/advocacy/state-advocacy/pbm-reform This Podcast is focusing on discussions & interviews about PBM Reform & those and Business of Pharmacy professionals leading this much needed reform.
Coverage is not Care with David Balat | PBM Reform Podcast
PBM Reform Podcast
29 minutes
1 year ago
Coverage is not Care with David Balat | PBM Reform Podcast
Openness. Competition. Transparency.
Unmask the twisted economics of the American health care system.
Price discovery — prior to care — allows patients to shop for care in a competitive market. It empowers them with the information they need to reduce their healthcare costs. And it encourages providers and insurers to compete for their business.Report: Free2Care’s Rx for Reforming America’s Predatory Healthcare System A Physician-Led Roadmap to Patient-Centered Medical Carehttps://free2care.org/files/report.pdf
The PBM-Insurer Mafia Comes for Community Pharmacies
UnitedHealth, CVS, and Cigna’s PBMs are using their market share and pull in Washington to drive one of the key levers to manage health care costs—independent pharmacies—out of business.https://prospect.org/health/2024-03-21-pbm-insurer-mafia-community-pharmacies/About David Balat:David Balat is the founder of Healthcare Finance Specialists and has broad experience across the healthcare spectrum with special expertise in health care finance. He is a former seasoned hospital executive with over 20 years of healthcare industry leadership and executive management experience.
Balat has earned the privilege of being invited to testify before the U.S. House Committee on Oversight and Reform in Washington, D.C., and before various House committees in the Texas state Legislature. He is a published author and op-ed columnist in Newsweek, U.S. News & World Report, Real Clear Politics, and other news outlets. He is also an active speaker and commentator on matters of health policy, health care finance, and health care reform.via decent.com
PBM Reform Podcast
Pharmacy benefit managers were created as middlemen to reduce administrative costs for insurers, validate a patient’s eligibility, administer plan benefits, and negotiate costs between pharmacies and health plans. Over time, PBMs have been allowed to operate virtually unchecked. A lack of transparency in PBM practices has led several states to implement licensure/registration, fair pharmacy audit, or generic drug pricing legislation to try to level the playing field for pharmacies and patients. by the NCPA https://www.ncpanet.org/advocacy/state-advocacy/pbm-reform This Podcast is focusing on discussions & interviews about PBM Reform & those and Business of Pharmacy professionals leading this much needed reform.
