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Plans begin ACO development in commercial marketsLarge health plans across the country are diving into accountable care with some degree of success.
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Comparing the Responses to COVID-19 in Israel, Canada and JapanInternational comparisons shed light on responses to pandemic and strategies for vaccination and reopening.
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Process upgrade solves consumer cash questionsOften when a patient walks into a provider's office, he or she might not have any idea about the total cost of the visit-except what the copay might be.
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Medical Jargon, Acronyms that Most Confuse PatientsHow skipping industry acronyms and jargon and using simple terminology will eliminate confusion and misinterpretation.
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Opinion: 5 Ways MCOs Can Address COVID-19 TransmissionPrincipals of DeltaSigma, LLC , Don Hall, M.P.H., and Sherry Rohlfing provide Managed Healthcare Executive an opinion piece on how managed care organizations can address COVID-19 transmission.
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Headed in the Right Direction: Cancer Mortality is Going DownPublic health policies and treatment advances have made a difference.
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Do pay-for-delay agreements buy antitrust uncertainty?Agreements must be judged by antitrust’s rule of reason to determine true consequences.
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BLOG: Look beyond pharmacy claims to detect fraudAdvanced analytic solutions are being used to detect improper payments in pharmacy claims.
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CMS eyes bundled payment pilot for specialist physiciansThe initiative would expand Medicare’s present Bundled Payments for Care Improvement (BPCI) program
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Dysfunction at the FDA, NIH, Elsewhere | Predictions for 2025Predictions for this year from Perry Cohen, Pharm.D., CEO of the TPG Family of Companies and Managed Healthcare Executive editorial advisory board member.
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How Current Accreditation Approaches Impact Reduction of Hospital ReadmissionsHospitals are always looking for ways to reduce readmission rates. They may have an unusual ally in a quality control system originally developed in Europe for the manufacturing sector. Read more about it.
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Five Tech Predictions for Healthcare in 2018In the year ahead, we can expect to see an insurgence in technology solutions that address patient engagement, data, and security throughout the healthcare system.
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Three Essentials Providers Need for Risk-Based ContractsThese core elements make up a collaborative “provider enablement” strategy to break down resistance to value-based care.
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Take a three-pronged approach to defined contributionConsumer focus is an enterprisewide strategy
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Four Ways Health Plans can Guide Members to Wise ChoicesFor all health plans, increasing complexity requires rethinking the presentation of options to members. Choice design, stepped information reveal, high quality, and timely communication, are keys to providing members a helpful and trustworthy healthcare GPS.
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Four Ways to Leverage Artificial IntelligenceHere's how artificial intelligence improves the healthcare ecosystem.
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How to Develop a Targeted Care Management Approach for Addressing Social Determinants of HealthThis type of focused approach incorporates four key steps.
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Five Steps to Improve Healthcare Consumer ExperienceTo build trust, health insurers need to demonstrate their value to customers. That means offering a convenient, satisfying customer experience. Here’s how.
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News You Should Know: 3 Takeaways from Top Managed Care Articles JuneHave two minutes? Listen to this quick podcast for critical takeaways from three of our top articles.
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New Reimbursement May Level Playing Field for BiosimilarsThe new Bipartisan Budget Act of 2018 (to be in effect on January 2019) institute new reimbursement guidelines for biosimilars under the Medicare coverage gap discount program that remove disincentives for biosimilar uptake and level the playing field for the future market place.
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New Reimbursement May Level Playing Field for BiosimilarsThe new Bipartisan Budget Act of 2018 (to be in effect on January 2019) institute new reimbursement guidelines for biosimilars under the Medicare coverage gap discount program that remove disincentives for biosimilar uptake and level the playing field for the future market place.
Latest:
New Reimbursement May Level Playing Field for BiosimilarsThe new Bipartisan Budget Act of 2018 (to be in effect on January 2019) institute new reimbursement guidelines for biosimilars under the Medicare coverage gap discount program that remove disincentives for biosimilar uptake and level the playing field for the future market place.
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4 Ways You Can Keep PHI SecureWhat are the best ways for healthcare executives to keep protected health information secure? Here are some tips.
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Innovation Isn’t So Hard After AllWhat a movie can teach you about innovation in your organization.
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CMS to Cover Next-Gen Sequencing for Cancer: Implications for MCOsIn a decision reached through the joint FDA/CMS Parallel Review process, CMS has granted national Medicare coverage to next-generation sequencing tests approved or cleared by the FDA as companion diagnostics for cancer therapies. This is clearly a win for Medicare beneficiaries and some NGS test providers-but is it also good news for MCOs?
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CMS to Cover Next-Gen Sequencing for Cancer: Implications for MCOsIn a decision reached through the joint FDA/CMS Parallel Review process, CMS has granted national Medicare coverage to next-generation sequencing tests approved or cleared by the FDA as companion diagnostics for cancer therapies. This is clearly a win for Medicare beneficiaries and some NGS test providers-but is it also good news for MCOs?
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Closing Care Gaps: Chart Chasing Has Become ObsoleteFor far too long, chart chasing was the best method health plans had to improve HEDIS® measures and Medicare Star ratings. Now, there is a better way.
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Top 3 Problems with Healthcare Organizations’ Content StrategiesVirtually all healthcare leaders recognize the value of content creation, yet the use of a well-defined content strategy is rare. Here’s how to get yours.
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Top 3 Problems with Healthcare Organizations’ Content StrategiesVirtually all healthcare leaders recognize the value of content creation, yet the use of a well-defined content strategy is rare. Here’s how to get yours.
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A Look at the Two Sides of Bundled PaymentsWhy some health plans have mixed feelings on adopting bundled payments and what it can become.
