CMS Proposes Significant Policy Changes for the 2015 Medicare Advantage and Prescription Drug Programs

CMS Proposes Significant Policy Changes for the 2015 Medicare Advantage and Prescription Drug ProgramsPosted by Kelly Sauders, Partner, Deloitte & Touche LLP

On January 6, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a 678-page proposed rule with numerous provisions that could have an extensive impact on how the Medicare Advantage (MA) and Medicare Part D programs operate. Although it’s likely that modifications will be made before the rule goes into effect, MA plans should still familiarize themselves with the proposed changes so they can understand the potential impact and determine what actions might be required to get ready. In some cases, plans might also want to take the opportunity to weigh in on the subject and help shape the new rule.

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Risks and Challenges of Expanded Retail Pharmacy Offerings

Risks and Challenges of Expanded Retail Pharmacy OfferingsPosted by Kelly Sauders, Partner, Deloitte & Touche LLP

Many retailers are considering expanding their pharmacy offerings to tap into bigger margins and new revenue sources. Attractive opportunities range from high-priced specialty drugs to a variety of health and wellness services. However, as retailers broaden the scope of their pharmacy operations, they are likely to encounter a number of significant regulatory issues and risks. Including:

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Follow the Lead

Follow the LeadPosted by Kelly Sauders, Partner, Deloitte & Touche LLP

A growing number of retailers are actively expanding their businesses to include pharmacies and other health and wellness services. These organizations, whether they realize it or not, are essentially becoming health care companies. As such, they need to look beyond their traditional retail practices and begin to adopt leading practices and technologies from the health care sector.

Data analysis is an especially promising area. Many of the retailers we have spoken with have expressed more than a little frustration about the complexity and opacity of the health care system — particularly the payment process — and lamented the lack of available information and insight to help them streamline their operations and make smarter business decisions. Yet, in most cases the insights they are looking for are already at their fingertips; they just need the right analytical tools and techniques to unlock those insights from their existing data.

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