Insights & Articles


Centene to pay $166 Million to Texas in Medicaid drug pricing settlement

Texas is at least the 12th state to settle with St. Louis-based Centene Corp. over allegations that it overcharged Medicaid prescription drug programs.

Revenue & Quality

Ad targeting Manchin and AARP mischaracterizes Medicare drug-price negotiations

A KHN and PolitiFact HealthCheck: The advocacy group American Commitment said empowering Medicare to negotiate drug prices would raid it of billions of dollars. Drug pricing experts say that that’s not the case and that such policies would instead reduce costs for the Medicare program and seniors.

Medicare Market

Conference previews: Two RISE master classes head to Nashville in August

Here’s a look at what we’ve planned for the Medicare Product Design Master Class and the RISE Part D Master Class. Both live, in-person events will take place August 25-26 at the Omni Nashville Hotel.

Pharmaceutical & Biotech

Top 5 features of TIPPA 2022, a live-streaming event

Back for its 21st meeting, The International Publication Planning Meeting (TIPPA) will be held as a virtual event on March 24-25. The conference will connect global stakeholders in biopharma, medical device/diagnostics, medical communication agencies, medical writers, and publishers for off-the-record discussion, networking, and idea exchange.

Revenue & Quality

Dems reach deal on drug pricing reform, allow Medicare D to negotiate prices directly with manufacturers

President Joe Biden and Congressional Democrats announced they reached a compromise plan for drug pricing that will reduce the costs of prescription drugs and insulin and finally allow Medicare to negotiate prices for high-cost prescription drugs.

Revenue & Quality

The public backs Medicare Rx price negotiation even after hearing both sides’ views

But Americans generally have little confidence that the White House or Congress will recommend the right thing, a new poll shows.


Pfizer court fight could legalize Medicare copays and unleash ‘gold rush’ in sales

Pharmaceutical companies routinely cover the cost of patient copays for expensive drugs under private insurance. A federal judge could make the practice legal for millions on Medicare as well.

Revenue & Quality

Issue brief: Millions of Medicare Part D enrollees have had out-of-pocket drug costs high enough to exceed the catastrophic threshold over time

The Kaiser Family Foundation (KFF) findings come as lawmakers in Congress consider establishing a hard cap on such spending.

Pharmaceutical & Biotech

RISE Radio Episode 9: Dr. Angela Huskey on emerging drug threats, the rise in substance use among the elderly

Angela G. Huskey, PharmD, CPE, senior vice president and chief clinical officer at Millennium Health, joins us for the latest episode of RISE Radio, our podcast series that focuses on issues that impact our three communities: Quality & Revenue; Member Acquisition & Experience; and Social Determinants of Health.

Pharmaceutical & Biotech

TIPPA 2021: A live-streaming virtual event to further medical communication strategy

The International Publication Planning Meeting (TIPPA) will be held as a virtual event on February 23-24. The conference will feature more than 25 industry experts who will explore the future of scientific and medical publications, the impact and engagement of digital innovations, and data integrity.

Revenue & Quality

Inside the first chaotic days of the effort to vaccinate America

Within just a few days, the logistical barriers of the vaccine made by Pfizer and BioNTech were laid bare. Many officials now hang their hopes on Moderna, whose vaccine comes in containers of 100 doses, doesn’t require deep freezing and is good for 30 days from the time it’s shipped.

Revenue & Quality

Supply is limited and distribution uncertain as COVID vaccine rolls out

High stakes and big challenges await as the U.S. prepares to roll out vaccines against COVID-19, with front-line health care workers and vulnerable nursing home residents recommended as the top priority.

Revenue & Quality

Feds finalize drug rebate rule, but mandate likely faces legal challenges

The Trump administration on Friday finalized the rebate rule, which excludes rebates on prescription drugs paid by manufacturers to pharmacy benefit managers and Part D plans from safe harbor protection under the Anti-Kickback Statute. The regulation is set to take effect Jan. 1, 2022 but is expected to face opposition.

Pharmaceutical & Biotech

TIPPA 2020: New conference features, hot topics on the agenda, and key sessions back by popular demand

Global stakeholders in biopharma, medical device/diagnostics, agencies, and publishers will convene at RISE’s 19th Annual International Publication Planning Meeting on Feb. 25-26 in San Diego.

Pharmaceutical & Biotech

Managed Care Pharmacy Innovation Summit to examine the role of the pharmacy and its impact on star ratings

Although the pharmacy profession has evolved over the last several decades, pharmacists remain an untapped resource within the health care industry. Indeed, health plans could see their star ratings improve if they work with pharmacists on innovative programs, says Victoria Losinski, PharmD, Ph.D., MBA, director of portfolio strategy and implementation, Blue Cross and Blue Shield of Minnesota, and a featured speaker at RISE’s upcoming Managed Care Pharmacy Innovation Summit. In this article, Losinski discusses strategies health plans can adopt to work with pharmacists to boost star ratings and health outcomes.

Pharmaceutical & Biotech

TIPPA 2019: Alcon Laboratories’ Val Injev on evidence-based publication planning challenges for medical device and diagnostic firms

Val Injev, global medical publications lead for Alcon Laboratories, will lead a breakfast breakout session on evidence-based planning for medical device and diagnostic professionals at RISE’s 18th Annual International Publication Planning Meeting, February 20-21, in San Diego. RISE talked with Injev ahead of the conference about the importance of working with developers earlier in the process to ensure that high-quality studies about new products or diagnostics are published as soon as possible in peer-reviewed journals.

Pharmaceutical & Biotech

TIPPA 2019: Keynote speaker Dr. Patti Peeples on what the latest HEOR, RWE developments mean for communicators and the publication planning industry

Patti Peeples, R.Ph., Ph.D., founder and CEO of HealthEconomics.Com, will be a keynote speaker at RISE’s 18th Annual International Publication Planning Meeting, February 20-21, in San Diego. In this exclusive interview, Peeples talks about the changes in health economics and outcomes research (HEOR) and real-world evidence (RWE) in the last three years and what they mean for the publication planning industry.