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ACO Final Rule Lowers the Bar for Forming and Operating an ACO – Not sure it really matters …

CMS today released the final rule on Accountable Care Organizations (ACOs); the rule can be found here Our review of the preliminary rule concluded ACOs, as designed, would have little effect on costs. CMS’ changes to the proposed rule are

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UNH 3Q is less about MLR, more about PBM

UNH plainly intended to subdue 2012 EPS expectations in their 3Q release, and the market seems to have read this through to other HMOs’ earnings prospects. We suspect this read-thru is incorrect Systematic earnings pressures for HMOs tend to take

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Below Zero and Falling Fast: R&D Productivity as an Enterprise-Wide Crisis

We estimate current returns on R&D spending of -7% – before costs of capital – for a typical R&D portfolio (typical in terms of # of projects, mix of projects by phase of development, and mix of projects by large

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President’s Budget Proposal Points to More Pressure on Innovators

  The congressional ‘super committee’ created by the Budget Control Act (“BCA”) this summer and tasked with cutting the cumulative 2013-2021 deficit by $1.2T by November 23[1] met for the third time on September 22. Ahead of that meeting, President

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A Detailed Comparison of the AWP Replacements: AMP v. NADAC

This note compares the two drug acquisition cost benchmarks (Average Manufacturer Price or AMP, and National Average Drug Acquisition Cost or NADAC) that CMS intends to make public. NADAC values have not been calculated or published; however because Alabama’s Average

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