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U.S. market access landscape: A push for control is erasing the boundary between payers and providers in U.S. healthcare

Clarivate

Oak Street has 169 locations across 21 states and expects to nearly double its size to 300 centers by 2026. CVS’ bid for Oak Street is in keeping with nearly two decades of evolution toward becoming an integrated payer and provider.

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How retailers and “payviders” are disrupting U.S. healthcare in 2024

Clarivate

In 2023, Humana’s care delivery component CenterWell launched a senior-centered “ Primary Care Anywhere ” program for in-home primary care in Georgia and Louisiana (where Humana leads the MA sectors) and increased senior membership in value-based home care models nationwide to more than 840,000.

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Making Sense of the Latest Changes to the Market Access Landscape

PM360

However, Medicare will only be able to negotiate prices for 10 Part D drugs in 2026, another 15 Part D drugs in 2027, another 15 Part D and Part B drugs in 2028, and another 20 Part D and Part B drugs for 2029 and subsequent years. It’s amazing we still separate the drug costs from overall healthcare costs,” Sontupe says.

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Specialty Treatments Require a New Approach to Affordability

PM360

As a mission-driven company and digital healthcare leader, GoodRx has helped patients obtain an estimated 80 million prescriptions they otherwise may not have been able to afford. United States Specialty Pharmaceuticals Market & Forecast 2020-2026,” BusinessWire, December 8, 2020. IQVIA Institute, March 2022.