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For decades, reformers have tried to move American health care away from cost-plus reimbursement and open-ended fee-for-service medicine toward competition, in which private plans negotiate hard and shift business to those offering better value. The new PBM regime would move in the opposite direction: toward regulatory supervision, standardized participation, and reduced discretion.

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But the Minneapolis company on Tuesday offered a solid annual profit outlook that was better than Wall Street had been projecting. It also said it believes net sales will grow every quarter this year.

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