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HIPAA Compliance in the Age of COVID-19Now is the time for compliance officers to get a better grasp on compliance and continuity across the organization.
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Maximizing Impact Through Strategic Research Investments That Address Unmet NeedsPatient organizations should focus on how they can be the most effective by leveraging their strengths to uncover new research opportunities.
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3 Ways to Reach Your Care Coordination and Communication GoalsIn this second part of a two-part article series, Curtis Gattis, CEO and co-founder of LeadingReach, discusses how healthcare organizations participating in risk-based contracting or value-based financial and care delivery models are currently facing major challenges with integrating, managing and tracking care coordination and communication capabilities within provider networks.
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Why Social Determinants of Health Are a Critical Factor for Preventing Member Risk Escalation in the Value-Based Care EquationMedicaid managed care organization (MCOs) may be better equipped to address social determinants of health (SDOH) and health equity than payers who use fee-for-service models because SDOH are central to many requirements for MCOs, including those pertaining to population health management, health equity and care coordination.
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Increasing Access to Effective Therapies for Atopic DermatitisCurrent strategies used to evaluate the performance of therapies used to treat atopic dermatitis and guide formulary decisions, and recommendations to help patients receive access to effective therapies.
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The Explosion in Genetic Testing — and How To Manage ItPayers must be early adopters of managing genetic testing through DEX Z-Codes, combined with science-based policies and policy adherence and claims editing technology.
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Future Modalities for InfertilityLucy van de Wiel, PhD, discusses how emerging technologies such as in vitro gametogenesis and gene editing show promise for addressing complex infertility cases, potentially revolutionizing reproductive medicine by offering new solutions for patients with genetic disorders, same-sex couples, and those with uterine factor infertility.
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7 Skills Healthcare Executives Need to SucceedThe COVID-19 pandemic has tested every healthcare executive’s ability to adjust — and adjust again. From mid-March through summer and now early fall, the ups and downs of the outbreak have occurred at a furious, unpredictable cadence.
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Keys to Effective Remote Patient Monitoring in the COVID-19 PandemicHealth organizations that had RPM solutions in place pre-pandemic have been more successful at scaling up than organizations that were starting from scratch during the pandemic.
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Now More Than Ever We Should Take Advantage of the Transformational Benefits of AI and ML in HealthcareArtificial intelligence and machine learning can take on simple tasks in healthcare so people can focus on collaboration and work on a higher cognitive level.
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The Future of Idiopathic and Progressive Pulmonary Fibrosis TreatmentAn expert physician discusses the potential role of novel agents in the management of idiopathic and progressive pulmonary fibrosis.
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Government Agencies Using AI to Detect Healthcare FraudHere’s what you need to know and do considering the DOJ’s and HHS’s drastically expanded use of digital tools to investigate and prosecute those who work in the field of healthcare, including innocent practices and providers.
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Health Plan CIOs: Essential Elements for SuccessThe technology infrastructure of many health plans today could be described as costly, fragmented and siloed. Rather than focusing on the customer experience, growth and transformation, these plans are responding reactively to business needs and market shifts.
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Getting Real About Health EquityCMS and state officials are using payment incentives, data collection and program requirements to start edging the lofty ideals of health equity toward reality.
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Using the Healthcare Utility Model to Manage Pharmacy Cost for Patients and PayersCivicaScript, a generic medication manufacturer, is modeling itself as public utility. It launched its first product, abiraterone 250 mg tablets, late last year and is gearing up to make its own low-cost insulin.
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Contract Management in a Value-Based Care EnvironmentFor operational efficiency, value-based initiatives need a scalable digital infrastructure that can handle multiple reimbursement models, including fee for service.
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The Future of Neurokinin-Targeted Therapies in Patients With VMSA panelist discusses how neurokinin-targeted therapies can be strategically combined with existing treatments to address multiple vasomotor symptoms (VMS) while highlighting their positive impact on patient quality of life, noting ongoing needs for long-term safety data and improved accessibility.
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Out-of-Pocket Limits Increase Utilization | Predictions for 2025Jerilyn Arneson, Pharm. D, co-founder and officer of the National Association of Medication Access & Patient Advocacy, gives her 2025 prediction.
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Opportunities for HIV PrEP in Population HealthThe benefits of addressing barriers and increasing access to HIV PrEP therapies to high-risk populations across the globe.
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Enhancing Provider-Patient Relationships to Reverse Chronic DiseaseThe existing approach to chronic disease management is ill-suited to address the dynamic and diverse factors at play with chronic illness, argue the authors. Increase patient engagement and tailoring care to address root causes can create a large value-add, they say.
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Opinion: A Biden win, a Republican Senate and a slim Democratic majority in the House: That’s a recipe for compromise.With the 2020 election season nearly behind us, conventional wisdom is that we will have divided government: a Democratic president, a Republican Senate and a razor-thin Democratic majority in the U.S. House of Representatives. That combination is a recipe for compromise on President-elect Joe Biden’s healthcare priorities; namely, the federal response to the COVID-19 pandemic and adjustments to the ACA.
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Why Timing Matters When It Comes to PBM ContractingPlan sponsors should begin evaluation of PBM performance at least a year before the contract expires, say lawyers with expertise in PBM contracting.
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Important Takeaways Regarding the Utilization of RuxolitinibPanelists discuss how ruxolitinib offers significant advantages in atopic dermatitis management through its targeted JAK inhibition mechanism, demonstrating rapid and sustained improvement in itch and lesions, effectiveness across various disease severities and body regions, favorable safety profile compared to systemic alternatives, and potential for reduced healthcare resource utilization over extended treatment periods.
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To Proactively Address SDOH, the ‘Top of Funnel’ is CriticalWe can identify and engage the right people. But to make a real difference in any community, a managed care organization, government agency or healthcare system needs to have a robust list/dataset of its population so the tools, processes and individuals that come after can do the work to identify and engage members with the highest needs.
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What’s Next in Healthcare Mergers & AcquisitionsLast year was a record setting year in worldwide merger and acquisition activity across multiple industries, and healthcare was a big part of that.
