Here we go again, half off of the $4.00 prescriptions already offered by Kroger, Walmart and others.  This may not sound like a big deal if you are already paying $4.00 but your data and prescription refill information is like gold and part of the reason for new programs emerging all the time to entice those to enroll so the process can begin.  This service for Medicare Part D starts after the first of the year.  Earlier this year, United started offering pharmacists pay for performance money for signing individuals up for specific programs so they could analyze who is “at risk” of developing diabetes and part of the process and numbers could have medication data in there.  Certainly imagethere’s nothing wrong with trying to live a healthier life and eat correctly but when you know someone is out there motivated by money and goals with pay for performance, it kind of takes the wind out of the sales with one wondering “am I really at risk or is it an over zealous person looking to make a few more dollars”? 

UnitedHealthCare To Use Data Mining Algorithms On Claim Data To Look For Those At “Risk” of Developing Diabetes – Walgreens and the YMCA Benefit With Pay for Performance Dollars to Promote and Supply The Tools

The data end of United, Ingenix can’t get enough data these days to analyze and recently started a new consulting and marketing arm too. 

You can read more about Ingenix MedPoint here.There’s also a flash presentation where you can view the process here.

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“By increasing understanding of potential disease conditions and relative risk, MedPoint enables underwriters to more accurately project future claims costs on a case-by-case basis.”

I’m not at the age level yet, but if I were, I’s stay with my Target or WalMart $4.00 prescriptions if they are available there as I kind of like my privacy.  My mother who has been on a Medicare Part D plant for a while has already received the brunt of all of this with compliance phone calls asking questions and the health plan and the drug store duking it out over whether she reads her glucose twice or 3 times a day and at twice a day, this cuts into profits if enough people are 2 times a day versus 3 but her doctor says twice a day is fine and she’s be at this for 15 years, so she knows the ropes.  You can read more about some of the compliance and marketing efforts she has been exposed to below. This is the real world with everyone in your face and everyone thinking they are the “Shell Answer man” even before they have had a minute to listen as that usually doesn’t occur too much today as they have “their data” so they can come off a bit lie the Gestapos at times.  The one call that really got me was the random calling by some diabetes association asking “is there a diabetic in the house”.  They have their data created by those algorithms that profess to make them right, right? <grin>. 

Compliance Police Out In Force for Seniors–Health Plans and Drug Stores Making Phone Calls-Business Models & Caller Behavior Sucks -A Result of Pay for Performance Efforts?

In other related United Healthcare news, the CEO of UnitedHealthcare's West Region has taken a seat on the board of a biopharmaceutical company, NeurogesX whichimage produces pain patches and the main ingredient is made in Taiwan for the patches which kind of brings me around to this division of United Healthcare with their acquisition of a China company that is working to get more Chinese drugs and devices into the US and globally.  No word on where the Twain location of the patch company gets their raw material.  I don’t think it’s being made in the US, unless I missed something? 

UnitedHealth subsidiary (Ingenix Subsidiary I3) Acquires ChinaGate – Working to Sell Chinese Products Globally

United of course has no cap on what their management can earn or what is spent on lobbying and as we all know with all subsidiaries reporting income, they are having one more banner year of profits. 

UnitedHealth To Pay Out Higher and More Frequent Dividends to Share Holders, No Caps on Earnings for Executives or What Is Spent on Lobbying Says the Board

Anyway, back on track through these new contracts, the lowest price could be the co-pay amount or the $2.00 as advertised and their “robust” formularies (who writes this stuff anyway, robust”) will list all the drugs in the plan.  You can review and take a look at the website here and I am guessing they will be after more pharmacies to come on line with more contracts soon, just a guess on my part but kind of the way healthcare is operating today and healthcare data is almost like gold today as every carrier sees any claim paid out as a loss, the words of Wendell Potter who spent many years on the other side.  BD 

MINNETONKA, Minn., Nov 23, 2010 (BUSINESS WIRE) -- UnitedHealthcare, a UnitedHealth Group company, announced a new program that will enable enrollees in the company's market-leading Medicare plans to save money on hundreds of prescription medications in 2011. This new program applies to the company's Medicare Part D members in 2011, including most of those who receive their prescription drug benefits in conjunction with a Medicare Advantage plan from UnitedHealthcare, such as AARP(R) MedicareComplete.

Through collaboration with The Kroger Co., Safeway Inc. and Prescription Solutions, UnitedHealthcare has created Pharmacy Saver, a unique program that reduces members' out-of-pocket costs on prescriptions purchased at pharmacies participating in the program to prices even lower than their co-payments, sometimes as low as $2 for a 30- or even 90-day supply. Pharmacy Saver applies to hundreds of prescription drugs, including eight of the top 10 generic drugs most commonly used by UnitedHealthcare's Medicare plan members.

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Pharmacy Saver will provide UnitedHealthcare's Medicare plan members valuable cost savings plus the flexibility and convenience of accessing their prescriptions at many of America's most popular pharmacies. Beginning Jan. 1, 2011, members can take advantage of Pharmacy Saver at more than 3,000 pharmacy locations nationwide.

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The Kroger Co. and its wholly owned affiliates that have in-store pharmacies: Kroger; Ralphs; King Soopers; City Market; Dillons; Smith's; Fry's; QFC; Baker's; Owen's; JayC; Hilander; Gerbes; Pay Less; Scott's; Fred Meyer Safeway Inc. and its wholly owned affiliates: Safeway; Vons; Randalls; Genuardi's; Carrs; Dominick's; Pavilions; Tom Thumb Prescription Solutions mail order pharmacy, a UnitedHealth Group company

UnitedHealthcare Introduces Pharmacy Saver for Medicare Plan Members - MarketWatch

1 comments :

  1. Everyday some thing or the other rules will be modified, changed or introduced, Sick of these Medical insurance companies.

    ReplyDelete

 
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