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Healthcare’s Time is Now to Take Operations VirtualKristin Ficery, who leads Accenture’s North America Health, discusses recent Accenture research that discovered since the onset of COVID-19, 60% of patients want to use technology more for their healthcare. And nine out of 10 patients said quality of care was “as good or better” than before COVID-19.
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Going on Offense Against Fraud, Waste and Abuse in Behavioral Telehealth: 3 Key ActionsTelehealth, especially for behavioral health, has created new opportunities for dishonest individuals to file fraudulent claims. Health plans can take steps to stop the fraud before it happens.
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Accurate, Specific and Comprehensive Documentation Moves the Needle in Value-based CareProper documentation and coding provide better patient care and help plans optimize revenue.
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Patient Engagement: Access is the Future of HealthcareThe pandemic has brought patient self-service to the fore.
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Polypharmacy and the Pivotal Role of the PayerA SCAN Health Plan "deprescribing" program is working to identify unnecessary prescriptions. In 2023, the program resulted in an estimated $2 million in savings from avoided fractures, falls, visits to the emergency room and other adverse drug events.
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The Urgent Case for Proactive Behavioral HealthcareThe healthcare system is facing an onslaught of patients with new and worsening conditions due the COVID-19 pandemic, but it is nowhere near ready to accommodate them.
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Potential Impact of Emerging PPF Treatments on Patient Outcomes and Health Ccare Resource UtilizationPanelists discuss the potential role of emerging treatments in the progressive pulmonary fibrosis (PPF) landscape if approved, exploring how they could address key unmet needs, improve patient outcomes, and optimize healthcare resource utilization.
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How COVID-19 Has Revealed Cracks in the Mental Health Support System for Healthcare WorkersManagers can help by removing any stigma against seeking help and providing access to support groups and professional services.
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Incidence of Lung Neuroendocrine Tumors Nearly Tripled Over Two Decades, Study FindsAlthough neuroendocrine tumors of the digestive system have been studied, far less is known about those that develop in the lungs, even as their incidence appears to be on the rise.
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The Well-being Measurement ProblemSurveys are important, but respondents may hide their true thoughts and feelings.
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Profits of Publicly Traded Health Plans Surge Amid Requests for Higher RatesAmid struggling providers, furloughs of essential workers, years of premium increases and record high earnings, for-profit health plans should consider options for directly helping their networks.
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Key Takeaways for Managed Care Organizations as No Surprises Act Goes Into EffectThe No Surprises Act is scheduled to go into effect in January. The law will require providers to provide patients with details of the new balance billing requirements, any state-level limitations or prohibitions in the state of service, and the dispute resolution process.
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Potential Urology Drug Savings Through Mark Cuban Drug CompanyThe greatest savings are seen for 90-tablet prescriptions.
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Transforming Healthcare Workforce for Future ChallengesDiscover how healthcare is evolving, the workforce hurdles it faces, and the game-changing role of technology in overcoming these obstacles.
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Powerful Antibody Shows Early Promise in Metastatic MelanomaAn engineered CD40 antibody that can bind to a specific immune receptor and directly injected into tumors has demonstrated in a phase 1 trial that it can trigger a systemic immune response.
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Unlocking Better Health: Why Health Literacy Needs a Digital RevolutionArtificial intelligence stands out as a particularly promising solution to the challenges of improving health literacy.
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Embracing AI Wisely: A Health Plan Leader’s Guide to Benefits, Risks, and ReadinessThe authors provide a detailed framework for assessing the adoption of artificial intelligence.
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The Future of Care Demands a Virtual Health EcosystemAreas of focus in the virtual health ecosystem.
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Strategies to Help Health Plans Prepare for Risk Adjustment, Star Ratings ChangesOne of the changes that CMS has added is a Health Equity Index (HEI) reward to its Stars program. The agency will use HEI data collected this year and next to calculate 2027 Star Ratings, so plans must capture member data on every measure included in the HEI.
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As Boundaries of Specialty Pharmacy Change, So Must Patient Support Services | Asembia AXS25Specialty drugs are increasingly entering general medicine. Experts at Asembia’s AXS Summit say the trend will put a premium on leveraging artificial intelligence, technology and cross-functional expertise to create more personalized, efficient patient support services.
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Patient Engagement: A Key Element for Success in Value-Based CareTo support a value-based care model, healthcare organizations should focus on creating meaningful engagement throughout the patient's journey. This includes contacting patients at the right time through the right channel with relevant messages.
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CMS’ RADV Strategy Will Reverberate Throughout Health Plan OperationsTo prepare for CMS’ new risk adjustment data validation (RADV) strategy, Medicare Advantage plans must take a coordinated, organization-wide approach.
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The Impact of Vaccines on Long CovidResearch suggests that COVID-19 vaccination may serve a therapeutic effect, possibly reducing the risk of developing long COVID when administered to those currently infected.
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CAR T-cell Therapy Shows 6-Year Durability in CLL PatientsA study suggests that a novel CAR T-cell therapy could be a curative treatment for some patients with chronic lymphocytic leukemia, with 25% of responders still in remission after 6 years.
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Shifting to an Endemic: How Tech Will Enable Greater Access to Affordable HealthcareThere are three key facets that must be considered in order to meet the demands of an endemic - the ongoing acceptance of a baseline of COVID-19 infection rates that will be maintained for the foreseeable future.
