Article
13 May 2025 - by Michael T. Hunter, Kali Schweitzer, Jay Blomquist, Mat Khan, Pepper Huang
For some people with diabetes, hypertension, or hyperlipidemia, there’s a stronger relationship between medication adherence and lower healthcare costs for patients with high risk scores.
Article
24 March 2025 - by Alan Van Amber, Michael T. Hunter, Jay Blomquist, AJ Ally, Ryan Cloninger, Stephen Wolff
The emergence of cost-plus reimbursement models in the pharmacy channel presents a promising alternative to better align reimbursement with acquisition costs.
Article
13 September 2022 - by Michael T. Hunter, Katherine M. Holcomb, Carol J. Kim
The 340B program allows participating hospitals to obtain certain outpatient medications for reduced costs.
Article
16 December 2019 - by Anna Bunger, Michael T. Hunter, Carol J. Kim
Article
03 June 2019 - by Anna Bunger, Katherine M. Holcomb, Michael T. Hunter
Failing to account for rebates overstates the net impact of pharmacy costs to a payer’s total costs.
Article
12 April 2019 - by Michael T. Hunter, Emma Kramer, Simon Moody
This article summarizes the key issues providers need to consider before taking on Part D risk, an increasingly common ask from Medicare Advantage organizations, and highlights some of the complexities and common barriers observed when advising provider clients on their strategies for Part D risk.
Article
13 March 2018 - by Jason Gomberg, Michael T. Hunter, Carol J. Kim
This report replicates portions of the 2015 U.S. Government Accountability Office 340B report (a comparison of the per Medicare beneficiary hospital pharmacy outpatient drug spending at 340B hospitals and non-340B hospitals) on a commercially insured population to determine if the relationships found in the Medicare population existed in the commercial markets.
Article
18 August 2017 - by Michael T. Hunter, Michelle (Klein) Robb, Jason J. Petroske, Alan Vandagriff
The Centers for Medicare and Medicaid Services (CMS) is adding a new prescription drug category classification system to the 2018 risk adjustment model, and this paper approximates the likely CMS mapping based on the publicly available information to date.
Article
24 December 2015 - by Jason Gomberg, Michael T. Hunter
An analysis of 2014 Part D plan profitability to determine if specific pharmacy channels are associated with members that may be more or less profitable for a Medicare Part D carrier.
