âManaged care began to be developed as early as 1917, with both private and government payers established by the mid-1960s. Medicare and Medicaid are the major government payers, with the health care reform legislation of 2010 providing changes for both. That said, private payers, such as regionals, nationals and blues plans, may take the brunt of the reform policies put in place.
The health care reform legislation in 2010 was the product of extended debate and compromise. The legislation will mean huge changes for the insurance industry if it is enacted. However, the more controversial aspects of the legislation, particularly the Mandate for health insurance, have resulted in numerous challenges.
For pharmaceutical companies, there are potential gains and challenges. Much of the 2010 health care reform legislation is very positive for the industry. If the Supreme Court ruling or the November elections mean that all or much of the legislation is scrapped, then the industry will again have to spend millions of dolloars in lobbying to ensure similar gains in whatever legislation takes its place. Working with payers will also provide the industry with challenges of increased pressure for generics, but may provide opportunities for pharmas to further their relationships with providers.
The report, âThe Payer Landscape in the United States â The Pharmaceutical Industry Faces a Rapidly Changing Marketplaceâ, was written to support pharmaceutical companies with their strategic plans to grow their businesses and prepare for future challenges theyâll soon face within the changing health care playing field.
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Scope
â Development of payers in the US including history of payers, types of payers
â Details on government payers â Medicare and Medicaid and top private payers
â Health Care Reform and payers â 2010 legislation
â Payer Response to health care reform â changing the...