Author Archives: Christopher Webb

The 39th Annual Eastern Medicaid Pharmacy Administrators (EMPAA) Conference was held this past week in Stowe, Vermont, at the beautiful Stowe Mountain Lodge in the foothills of the Green Mountains. EMPAA is a non-profit association of representative members from State Medicaid Pharmacy programs in the Northeast. The organization holds an annual meeting to share and […]

RJ Health Systems is very pleased to announce that Paul D. Rector will take over as CEO, effective November 16, 2015. Mr. Rector previously joined RJ Health Systems in February 2015 as Executive Vice President, Sales and Business Development. With 20 years of sales, marketing, and product development experience across healthcare, media, financial services and […]

ICD-10 is upon us. There was no last ditch effort to block ICD-10 like there has been in the past. The transition from ICD-9 to ICD-10 has happened. As of today, technical implementation of ICD-10 was a success however, many people were not overly excited for ICD-10. Early feedback expressed concern about readiness training, some […]

The Blues Information Management Symposium (IMS) was hosted recently by Florida Blue at the Ritz-Carlton in beautiful Amelia Island, Florida. The Blues IMS is an annual conference started in 2000, presented and hosted by different Blue Cross Blue Shield (BCBS) Information Professionals every year. Most recently, Blues IMS was hosted by Excellus BlueCross BlueShield in […]

With only days to go before the ICD-10 deadline, most health plans, PBMs and HMOs are ready. The results of a RJ Health Systems survey showed that 59% of respondents are ready for the October 1st transition date. But there are still 41% surveyed who will be playing catch-up past the date, or are not […]

Two of the key problems facing the specialty drug industry today are: Utilization Management; applying new tools for increasing control over appropriate use, and Drug Selection, also known as Formulary Management; shifting utilization to therapeutic equivalent and more cost effective alternatives. Over 47% of specialty drug utilization is managed by payors under the medical benefit. […]

Specialty drug trend continues to grow at 14-25% annually and it has become the number one drug management priority for payers. Specialty trend is driven primarily by Price, Drug Mix and Utilization and the imminent availability of the ICD-10 data standard creates new opportunities for utilization management programs that can reduce trend up to 7%. […]