article thumbnail

What’s Expected to Drive Up Health Plan Costs in 2025: GLP-1s, Behavioral Health, and Inflationary Pressures for Hospitals and Doctors – PwC’s Behind the Numbers 2025

Jane Sarashon

Following the BLS report on the CPI for June 2024, PwC published their new annual report from PwC titled Behind the Numbers 2025 tells us that commercial health care spending is expected to grow some 8.0% (Motor vehicle insurance costs grew a whopping 19.5% in the report, FYI). for Group plans and 7.5% and 7.0%, respectively.

Doctors 59
article thumbnail

Medicare Prescription Payment Plan (M3P) Implementation: Key Considerations for Part D Plan Sponsors and PBMs

Innovaare Compliance

The upcoming Medicare Prescription Payment Plan (M3P), set to launch in January 2025, marks a significant shift in Medicare’s approach to prescription drug coverage. These requirements include: Detailed Reporting: Plans must submit comprehensive data on prescription drug pricing, utilization, and patient outcomes.

Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

The Health Insurance Premium for a Family Averages $25,572 in 2024 – KFF’s Annual Update on Employer-Sponsored Benefits

Health Populi

For Tier 3, only applicable to plans with three or more tiers, the average copay is $65 and coinsurance 35%; and, For Tier 4, again for plans with 3 or more tiers, the average copay is $128 and coinsurance a 33% share (generally applicable to specialty drugs).

article thumbnail

Medicare Prescription Payment Plan (M3P) Implementation: Key Considerations for Part D Plan Sponsors and PBMs

Innovaare Compliance

The upcoming Medicare Prescription Payment Plan (M3P), set to launch in January 2025, marks a significant shift in Medicare’s approach to prescription drug coverage. These requirements include: Detailed Reporting: Plans must submit comprehensive data on prescription drug pricing, utilization, and patient outcomes.

article thumbnail

CMS Releases Guidance on Implementation of Rebate Programs for Certain Medicare Part B and Part D Drugs

Healthcare Law Blog

All rebate payments will be deposited into the Medicare Prescription Drug Account in the Federal Supplementary Medical Insurance Trust Fund. September 20, 2025 The date by which CMS must invoice manufacturers for the Part B inflation rebates owed for calendar quarters in 2023 and 2024.

article thumbnail

Spending on Medicines In and Post-COVID Say a Lot About Patients and Larger Healthcare Trends – an IQVIA Update

Health Populi

Spending on medicines, globally, will rebound this year and rise above pre-pandemic levels through 2025. Between 2021 and 2025, the annual growth global growth rate for prescription drugs spending is expected to range from 3% to 6%, a $1.6 As such, the debate on prescription drug pricing in the U.S.

article thumbnail

Health Provider News

Hall Render

Health Policy Commission still missing key document in Steward sale to Optum Local obesity drug developer lands deal worth up to $600M with Novo Nordisk Mass. Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ Dallas Home Health Company to Pay $4.7