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Where Are We Really With Interoperability?New interoperability rules could require significant changes for healthcare organizations, but everyone will benefit from these improvements.
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Countless Americans Have Lost Employer Coverage. What Can Be Done?In the four months between February and May, roughly 5.4 American workers lost their coverage.
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Health Plan Executives Like Transparency Benefits, but Say Compliance is ComplexAnother component of the government’s Transparency in Coverage mandate and No Surprises Act legislation for health insurance plans will go into effect on January 1, 2023 for price transparency.
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New Federal Rule Overhauls Health Insurers' Prior Authorization ProcessesThe rule comes as health insurers have increasingly been criticized for onerous and time-consuming prior authorization procedures that physicians say unfairly delay or deny the medical treatment that their patients need.
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Power to the Patients | Predictions for 2025A prediction for this year from Jason Spangler, M.D., M.P.H., CEO, Center for Innovation & Value Research.
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Homeless Does Not Have To Mean Health Plan-LessL.A. Care Health Plan and Health Net are teaming up to provide care for 85,000 people in Los Angeles County who don’t have housing
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Policymakers Must Take Action to Ensure Maternal Health Extends Beyond the Labor and Delivery RoomIf we look for the silver linings among lessons learned in 2020, the brightest positive outcome may be a better coordinated and more robust investment in public health. Yet as we continue to fight COVID-19 in the U.S., it’s important not to lose sight of another incredibly important battle we face on the public health front: maternal health.
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Staying Ahead of Employee Burn-outWorkplace stress is an inevitable part of business, but when stress gets out of hand, it’s bad for business and the people who do the work.
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7 Actions Every Health System CFO Needs to ConsiderHealth systems are struggling as a result of the reduced activity of elective procedures, the loss of health coverage for many employees, and the resultant drop in billings. According to this article, there are seven approaches recommended for immediate consideration to increase revenues and stanch losses.
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3 Cost of Care Strategies for Health Plans to Mitigate Revenue Losses From Medicaid RedeterminationHealth plan leaders should act quickly to implement cost of care strategies to help offset future Medicaid-related revenue losses. Steps they can take include careful reviews of pricing and of medical management to make sure that the services are medically appropriate and necessary.
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Pharma: Striding Towards the Digital-only Reality with AIAs industries across the board move towards a digital-only world, pharma companies must account for the different technologies that are transforming the R&D process.
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Telehealth – A Missed Opportunity?The doctor’s office waiting room is an age-old concept. We have waiting rooms because patients need to arrive early to ensure that the clinic runs on time and at near-full capacity. But clinics rarely run to schedule, so we end up wasting lots of time queuing to see a scarce, expert resource - the doctor.
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A Health Plan’s “No Regret” Strategy to Open EnrollmentThis year, health plans need to focus on the following smart, “no regret” investments in the enrollment process that have low risk, high reward, and ultimately deliver an exceptional member experience while simultaneously reducing costs and improving data quality.
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New Joint Commission Requirements Likely to Boost Maternal Patient SafetyThe outlook for decreasing the maternal mortality rate in the country has recently improved as a result of a recent initiative by the Joint Commission, which has developed 13 new elements of performance (EOPs) to help evaluate hospitals.
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Pegozafermin for Nonalcoholic SteatohepatitisThe drug has been engineered using a proprietary glycopegylated technology that is designed to increase its overall half-life.
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Early Trial of Libtayo Combination Demonstrates Activity in MelanomaFianlimab plus Libtayo demonstrated persistent and significant clinical activity in patients with advanced melanoma.
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Spinal Muscular Atrophy Drug Risdiplam Proves Success in InfantsPatients treated with risdiplam at 12 months demonstrated significant improvement in survival and developmental milestones, with 19 of 21 (90%) infants able to survive without permanent ventilation and 7 (41%) infants able to sit without support for at least 5 seconds.
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Designing a Better Peer-Support Experience for Patients, Caregivers, and SurvivorsThe process of building digital peer support experiences requires taking in feedback from users and their caregivers to address risk concerns, add new features and continuously improve the user experience.
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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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Addressing the Mental Health Needs of Seniors with a Value-Based Care Team ApproachCaring for seniors means attending to both their physical and emotional health. Unfortunately, the mental health of older patients is rarely evaluated and treated. Multiple barriers to care exist, including availability and access to mental health practitioners, as well as the stigma associated with psychological conditions that may prevent patients from seeking help.
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Questions Linger Around COVID-19’s OriginWe may never know where the virus came from, but the development and rollout of the COVID-19 vaccines has been the medical miracle of our lifetime.
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Inflation Reduction Act and the Impact on Pharmaceutical Pricing and Investment DecisionsThe reference to “maximum fair price” in the act bodes poorly for manufacturers and suggests more of a take-it-or-leave-it situation rather than a negotiation where clinical evidence would be the prevailing factor in determining price.
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Common Challenges in Health Systems of Great Britain and the United States Offer Valuable Learning OpportunitiesThe National Health Service provides some lessons — both good and bad — around models of coverage expansion.
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Medicaid Redetermination: 5 Reasons Why Texting is Essential for Reaching Members Before It’s Too LateThe average person checks their phone 58 times a day, so there is a good chance that a text message will be read.
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Using Predictive and Prescriptive Insights to Close Care GapsBy using a combination of predictive and prescriptive next best action insights, providers can close the gap in care for individual patients by leveraging a combination of data sources — clinical data, patient surveys, SDOH data, and consumer and behavioral data sets — and applying artificial intelligence techniques to create those insights.
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Paying it Forward: How Payers Can Accelerate the Transition to Value-based CareWith healthcare costs outpacing income growth and health insurance deductibles increasing by 212% over the past decade, many patients are left feeling that their health insurance doesn’t provide as much value as it did 10 years ago.
