New CMS equity initiative, tightening squeeze on PBMs, Civitas recap

Can you believe autumn is just around the corner? We are bracing ourselves for healthcare’s busy season marked by budget planning, a flurry of healthcare events and, of course, the holidays. There’s some striking news this month on a new CMS initiative for states, a tightening squeeze on PBM prescription costs, and survey results on a comparison of independent and corporate primary care services.  

  • A new approach to treating miscarriage. A Minnesota clinic is rewriting healthcare’s traditional approach to miscarriage by adding more personalized treatment. “If you neglect miscarriage, you miss that opportunity of really positively affecting not only the patient but her child, her parents, and her siblings for generations. That’s a legacy.” 
  • Blue Shield of California drops CVS pharmacy services to save on drug costs. CVS stock drops 8%, and Cigna and UnitedHealth Group stocks are hit, too. The Blue Shield announcement may hint at the potential for health insurers to abandon PBM services which have been blamed for inflating prescription prices.  
  • CMS provides states new incentives and flexibility to redesign healthcare delivery and improve access. The Advancing Healthy Equity Approaches and Development (AHEAD) model hopes to reduce costs, provide more equitable access, and improve total population health across states and regions by better attending to chronic disease, behavioral health, and other medical conditions. 
  • 2023 Civitas recap. Organizations that use health information exchanges taking a cross-sector approach to sharing healthcare data often collaborate via the Civitas Networks for Health, which held its annual conference in Maryland this August. A wide range of sessions touched on everything from technical implementation tips on interoperability strategy to panels on how data sharing has helped women, infants, children, American Indian, and Alaska natives. 
  • 54% of patients do not care whether their primary care provider is independent or corporate, a new survey from Software Advice found. Still, more patients prefer independent practices (38%) to corporate practices (8%). Corporate practices received high marks on speed and low cost of care. Independent practices scored high on personal relationships, care quality, and trust.   

What healthcare events have most affected your organization this month—and why? Let us know!   

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