The Healthy Muse
The PBM industry is seeing plenty of transformation this year. A few stories this week highlighted how this industry is evolving to a more patient-centered model, including more pricing transparency and heightened consumer focus:

The PBM industry is seeing plenty of transformation this year. A few stories this week highlighted how this industry is evolving to a more patient-centered model, including more pricing transparency and heightened consumer focus:

CVS Deal gets approved.

After a tumultuous 9 month run, a federal judge finally managed to approve the CVS-Aetna deal this week, paving the way for CVS to officially acquire Aetna (even though they’ve been operating as one entity for…almost a year). The approval comes at a time when CVS, traditionally a PBM player, is trying to transform its business model and the healthcare industry – even hiring a former Fitbit exec to lead its consumer health division.

Pharmacy Benefit Management’s evolution?

Ironically enough, though, the first industry to see significant change may be CVS’ core business of pharmacy benefit management. New startups are springing up, aiming for more transparency around the typically-shady PBM practice and a generally more consumer-friendly approach to the business. And don’t forget the heat the industry faced earlier this year from Capitol Hill.

Read for yourself an interview with PBM startup Capsule’s CEO, who talks about the changing industry. And another startup, Capital Rx (what’s with all the C names anyway?) just introduced a new way to price drugs in an itemized format.

more stuff

The mid-level takeover edition

This week in healthcare: UnitedHealthcare earnings, Carbon Connects with Froedert Health, NPs get full practice authority in New York, Bright Health is exiting 6 markets after a dismal 2021, public health emergency gets extended, and DaVita gets acquitted.

Why Inflation Destroys Provider Margins

If they aren’t already, providers are about to get killed by inflation. How do those dynamics affect healthcare provider organizations? How do healthcare services businesses stave off intense expense margin pressures while also increasing top-line revenue?

The Unstoppable Optum Edition

This week in healthcare: Breaking down the Intermountain merger with SCL Health, Optum continues its buying spree in purchasing Kelsey-Seybold, Hims & Hers partnership with Carbon Health, a 7 hospital health system merger in West Virginia, Aveanna’s bad Q4, CMS payment updates, Memorial Hermann’s urgent care JV with GoHealth, and lots of fundraising announcements.

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