Authors


Angie Jellish

Latest:

Elevating to ICD-10: It may be a great fit for healthcare

The World Health Organization's latest version of the International Classification of Diseases and Related Health Problems (ICD) will bring "the good, the bad, and the ugly" for nearly all who use this classification system. However, the biggest asset is that the latest version is much more detailed and organized than ICD-9.


Harris Meyer

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Return of the narrow network

Narrow, high performance networks are making a comeback.


Martin P. Hauser

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Exchanges would need local participation

State-level insurance exchanges are more likely to thrive in the market by taking advantage of integration


Allison Tsai

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Green initiatives growing among healthcare facilities

Reducing water and electricity use can produce immediate savings for hospitals while recycling efforts pay off in the longrun



Lonny Reisman, MD

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How Artificial Intelligence Can Help Health Plans Manage Chronic Conditions

Managing members with chronic conditions is a complex, costly challenge for health plans. Using AI to combine real-time patient data and guideline-directed medical therapy can help.


Tracey Grunsfeld

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Consumer-driven pharmacy plans must focus on compliance and safety

A recent survey by the Employee Benefit Research Institute found that 70% of those enrolled in consumer-directed health plans (CDHP) say that they consider costs when deciding to see a doctor or filling a prescription as compared with fewer than 40% of those in a comprehensive plan. However, the survey also found that CDHP enrollees were twice as likely to avoid, skip or delay healthcare services.


Jeff Bendix

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Consumers unwilling to change behavior to lower care costs

While patients may complain about the rising cost of their healthcare, few of them appear willing to do much about it, according to a new survey.


Paula Sauer

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Begin obesity programs in early childhood

Customize your obesity program for children, beginning as early as preschool


Jim Hardy

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Medicaid beneficiaries require improved case management

Medicaid beneficiaries require care management and case management services because there's a higher concentration of comorbid conditions and other significant issues in this population


Mark Belanger

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EHRs not sufficient for data liquidity

An EHR is one technology within the health IT portfolio, which also includes e-prescribing, clinical decision support, messaging and alerting, telehealth, consumer health information portals and other technologies


Susan Penfield

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EHRs not sufficient for data liquidity

An EHR is one technology within the health IT portfolio, which also includes e-prescribing, clinical decision support, messaging and alerting, telehealth, consumer health information portals and other technologies


Jason Goldberg

Latest:

Use of telehealth could save billions

If passed, the Medicare Telehealth Enhancement Act introduced earlier this year promises to greatly expand telehealth programs


Margo Edmunds

Latest:

EHRs not sufficient for data liquidity

An EHR is one technology within the health IT portfolio, which also includes e-prescribing, clinical decision support, messaging and alerting, telehealth, consumer health information portals and other technologies


Don Liss

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Medical home model invests in primary care

MCOs must evaluate outcomes of pilot programs before concluding that cost savings will follow quality trends


Alexander B. Reich

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Contraceptive coverage laws remain contentious

The contraceptive mandate stoked the legal fire of religious groups.


Christine Blank

Latest:

Young Adult Black Patients With Acute Myeloid Leukemia Patients Have Higher Death Rate

The younger Black patients with acute myeloid leukemia (AML) had “alarmingly high” early death rates within the first 30 days of study enrollment, indicating possible delays in diagnosis and care, according to research results reported in the journal Blood Advances.


Douglas Holtz-Eakin

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MA star-rating policy must be improved

Medicare Advantage's star rating program includes overly ambitious benchmarks.


Jill Sederstrom

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Plans, NGA examine infant mortality

Japan and the UK outrank the United States in infant mortality measures


Institute of Health Care Knowledge

Latest:

Helping People Help Themselves: Driving Participation In Health Improvement Programs

Programs designed to improve health and lower health care costs only work if people use them. In an effort to increase participation, Health Management Corporation (HMC), a wholly owned subsidiary of WellPoint, Inc., researched what drives health plan members to enroll and engage in programs to improve their health.


Summit Health

Latest:

Best Practices in On-Site Wellness Series: Guidelines for Choosing a Health Screening and Flu Shot Vendor

Today, more companies are implementing wellness programs in order to improve the health and productivity of their employees, while at the same time reducing overall health care expenses. However, it is easy to think of health screenings as a commodity instead of what they truly are ? health care.


Warren E. Todd, MBA

Latest:

Disease Management: a Look Back & Ahead

Disease management (DM) in the US can trace its roots back to the mid-1980s with the early work of California health plans and has come a long way since then. However, it wasn't until the mid 1990s that disease management became part of mainstream thinking, after several private for-profit companies introduced outsourced disease-management programs to large commercial health insurance providers. The "process/evolution" of DM in the United States has been and continues to be the major difference between disease management in the US and the UK...and other countries.


Marc Isaacson

Latest:

The Missing Link in Healthcare Reform Why Healthy Living & Prevention Aren't Part of the Plan...But Need To Be

At this moment in history, we have a real opportunity to re-invent and revolutionize our entire healthcare system. However, current proposals are nothing more than a band-aid, missing the chance for true healthcare system reform. The proposed "fix" does very little to keep healthcare sustainable 10, 20 or 30 years from now.


Naomi Neufeld, MD

Latest:

Intense family programs address motivation to reduce risk associated with weight

One case of a mother and child shows promise in family-oriented weight management and risk reduction


Neal Kaufman, MD

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Online management comes of age for chronic conditions

Online virtual lifestyle management must include evidence based programs that are flexible and integrated


Christina Severin

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Real-time data drives ACO effectiveness

Real-time data sharing plays big role in effective, high-quality care.


Douglas Moeller, MD

Latest:

A prescription for specialty pharmaceuticals: Transparency and collaboration for improving drug and diagnosis coding on medical claims

Since the completion of the Human Genome Project, the explosive growth in molecular diagnostics and specialty pharmaceuticals is outpacing the growth seen in any prior era, raising serious concerns about clinical quality and cost. According to an industry survey conducted earlier this year by the Pharmaceutical Research and Manufacturers of America (PhRMA), more than 900 medicines and vaccines have been identified in various stages of development. To keep pace, the strategies that were adequate for the “empty pipeline” scenarios of a few years ago-to code each agent, communicate clinical evidence and clinical guideline developments, and update reimbursement methodologies-must now be enhanced.


Doron Schneider, MD

Latest:

Include stroke prevention for members with Afib

Program for Afib patients could provide template of improved outcomes.


Mark Cziraky

Latest:

Information evolves for better decisions

Collaborative healthcare communities gather clinical and claims data to apply to real-world settings


Stanley Wulf, MD

Latest:

Patient feedback programs lower healthcare costs

If these programs are executed correctly, they can educate patients about their medications, provide physicians with information about the effectiveness of drugs and facilitate communication

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