Category Archives: Industry Insights

To Our Valued Customers: 2015 was an unbelievable year of growth for RJ Health, and we cannot thank you and your organization enough for being a part of our journey. We spent the year side-by-side with many of you in order to capture your “voice” and define our product roadmap. Here are five trends we […]

What: Specialty Drug Webinar on Biosimilars When: February 17, 2016 from 2 – 3 PM (EST) Click Here to REGISTER NOW  – Seats are Limited! Join RJ Health Systems for the final in a series of two webinars focusing on Biosimilars and what effect they will have on the Specialty Drug Industry. “Biosimilars – Management […]

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 […]

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 […]

The Magellan Rx Management Specialty Summit was held recently in New York City. RJ Health Systems’ very own Paul Rector was in attendance listening and connecting with thought leadership in the specialty drug space. Nationally-recognized payors, oncologists, and industry leaders explored and discussed the key issues, challenges and emerging trends facing an evolving specialty market […]

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%. […]