All Articles In 'Competition'
Redefining Health Care: Using Competition to Improve Quality and Efficiency
The world’s leading guru of competitive strategy, Michael Porter, Ph.D., has turned his sights on explaining the fundamental cause of high costs, poor quality, consumer dissatisfaction, uneven access, and skyrocketing premiums in American health care. In [...]
Massachusetts Health Care Reform Initiative: Briefing from Lead Advisors to Massachusetts
To learn about the Massachusetts health care reform initiative, here are two podcasts on this groundbreaking new program to cover virtually all the uninsured in the Commonwealth. For Sellers, Feinberg and Associates, the lead consultants on [...]
Medicare Drug Plans and Risk Mitigation: Risk Corridors, Risk Adjustment, and Federal Reinsurance
Being a Medicare prescription drug plan can be a profitable business. For the smart players, it will be highly profitable over time and indispensable to market position. But Medicare Part D can also be financially risky [...]
Transparency of Medical Prices: Informing Medicaid and Medicare Beneficiaries
It is an immutable truth of economics. Transparency is an essential ingredient for a market to function with any semblance of efficiency or effectiveness. Lack of transparency – what economists call asynchronous information – leads to [...]
Medicare’s Competitive Acquisition Program for Part B Drugs and Biologics: Understanding CAP
Coming on the heels of Medicare Part D and the new Part B drug-pricing schema based on Average Sales Price (ASP), the new Competitive Acquisition Program (CAP) for Medicare Part B drugs and biologics represents yet [...]
Medicare Advantage Special Needs Plans: Understanding an Untapped $250 Billion Market
Medicare Advantage Special Needs Plans (MA-SNPs) are an important new innovation in the healthcare marketplace. Ultimately, as I reported last fall in the Piper Report, MA-SNPs may evolve to serve an untapped $250 billion market. Here’s [...]
Losers in the New Medicare Drug Benefit
As promised, here’s my list of likely losers under the new Medicare prescription drug benefit: ● Dual Eligibles: These 6.5 million highly vulnerable beneficiaries will lose their Medicaid drug benefit and be enrolled in the less [...]
Marketing Challenges of Medicare Drug Plans: Reaching Medicare’s Diverse Population
The new Medicare prescription drug benefit presents major marketing challenges for both the competing drug plans and officials at CMS and SSA. While the feds must conduct a massive outreach campaign to educate 43 million Medicare [...]
Medicare Advantage Special Needs Plans: New Opportunities for State Medicaid Programs
Medicare Advantage is the new name for voluntary managed care options in Medicare (also know as Medicare Part C and formerly “Medicare+Choice”). Medicare Advantage plans are now available in nearly every area of the country. Beneficiaries [...]
Healthcare M&A: Lessons for Successful Mergers and Acquisitions
The health care sector is poised for more mergers and acquisitions, particularly in health plan and biotechnology segments. UnitedHealth Group’s deal PacifiCare is only the beginning of a hot M&A season the next couple years. Mergers [...]
Stay Connected
Managing Editor
