RJ Health was on the road over the last month attending AMCP and Asembia (formerly Armada) conferences, gaining insight into industry trends and interacting with our customers face to face.
At this year’s Academy of Managed Care Pharmacy (AMCP) Meeting in San Francisco from April 20th to 22nd, more than 4,200 managed care pharmacists and other health care professionals from across the country were in attendance to learn from Health Plans and Specialty Pharmacies about how to effectively manage specialty drug reimbursement. Industry experts presented on many topics effecting the medical benefit including Current Affairs in Specialty Pharmacy Management and Business Trends in Managed Care.
One insightful breakout session was “Evolving Rebate Contract Negotiations — Improving Efficiencies and Revenue” presented by George Jaresko, Director, Pharmaceutical Contracting, Blue Shield of California. He spoke of the challenges Payors and Manufacturers have when facing large variations in the formats of bid processes and agreements, as well as rationales around rebate rates and conditions for rebates. ReimbursementCodes is uniquely prepared to help Payors with rebate capture by converting HCPCS code units to NDC code units using our NDC Unit Conversion database file and module.
Next stop for RJ Health was Asembia’s Specialty Pharmacy Summit which took place May 2nd through 6th in Las Vegas. While AMCP was focused primarily on Managed Care, Asembia’s footprint is industry-wide, with attendees from all aspects of Specialty Pharmacy.
A common theme in Medical Benefit Management is to expect most Medical Benefit to be transferred over to the Pharmacy Benefit where it is easier to manage. However, a session presented by Lisa Morris, Staff Vice President, Clinical & Specialty Pharmacy, Anthem, thought otherwise. “Managing Specialty Pharmaceuticals: A Payor’s Point of View” expected to see Medical and Pharmacy spend to hit $400 Billion by 2020 with both segments sharing 50% of the $400 Billion. Medical Pharmacy Spend is alive and growing which makes it important now more than ever to have a system in place to manager your health plan’s specialty spend.
Many of RJ Health’s clients are Payors, so we’re constantly looking for ways to improve the way our data helps them with their problems. Our NDC Quality Solution combines ReimbursementCodes, RC Database and RC Claim Assist to support the development and enforcement of NDC billing policies at all levels of your health plan.