Health Management

Here are six steps experts say are necessary for success as an accountable care organization (ACO).

The real value of population health management lies not in the data it generates but in the interventions it drives, according to Jay Rajda, MD., medical director of Aetna's Innovation Lab.

FDA’s approval of the first generic version of Copaxone for treating patients with relapsing forms of multiple sclerosis has industry insiders contemplating the impact on the generics market as well as payer coverage strategies.

Payers and providers must consider the key differences between two consolidation models: "horizontal consolidations" and "vertical consolidations." Here's why.

Managed healthcare executives can set the table for future economic expansion of interoperability capabilities by following a few simple, straightforward tips.

More than 750 government and private ACOs are now in place, helping healthcare transition away from fee-for-service. Find out what's working and what's planned for the future.

As the number of people with diabetes in the U.S. continues to climb, plans and integrated health systems are employing personalized strategies to help manage the disease.

A new survey indicates consumers' biggest concerns about health insurance marketplace plans, and the top factors they consider when selecting a plan.

If we can accurately understand each patient’s risk for disease, we can create more nuanced preventive care plans and better invest our resources.

By working with service providers that are employing robotics and advanced analytics, organizations can leverage automation and innovation to address key challenges.

In this blog, the vice president of medical affairs for Quest Diagnostics discusses how Medicaid expansion has impacted diabetes diagnoses.

Streamlining equipment maintenance and repair processes presents an enormous opportunity for healthcare facilities to reduce expenses associated with outside technicians.

Several changes, from new payment models to the "Cadillac Tax," are impacting the health insurance market.

A new health rankings report indicates in which states health plans and health executives encounter the most challenges when caring for seniors.

Medicare beneficiaries with diabetes, high blood pressure or high cholesterol may achieve better health outcomes when using pharmacies that are part of performance-based networks, according to early results of a pay-for-performance program conducted by SCAN Health Plan and Express Scripts.

Only 5% of Medicaid-enrolled Americans account for 50% of total Medicaid spending, and the top 1% account for almost 25% of spending, according to a new study from the Government Accountability Office.

Even though e-cigarette smoking is on the rise, wellness programs are not giving smoking cessation nearly enough attention or resources, according to a new HealthMine survey.

Even though cancer screenings have become more available because of the Affordable Care Act, the percentage of adults getting certain cancer screenings has not increased significantly since 2010.

Wellness programs are a strategy to control rising healthcare costs, but according to a recent survey, many wellness incentives are meaningless to participants.

The Affordable Care Act has led to community-based approaches for super utlilizers like health homes that appear to be making inroads.

Consensus is building on the promise of genetic testing and other technological advances to help individualize testing, prevention and treatment for better outcomes.

Misreporting of data to the Centers for Medicare and Medicaid Services exposes MCOs to civil litigation and administrative penalties.

The number of deaths from prescription pain relievers dropped 5% in 2012, and new tools are helping in the fight against opioid abuse.

Research has been given a shot in the arm by Apple Corp, which recently expanded the use of ResearchKit to include clinical trials.

An ongoing challenge particular to plans serving duals is a gap between the plans’ reimbursement rates and the health status of the populations they serve.

A new survey from KPMG of 270 healthcare professionals found only 10% are using advanced tools for data collection with analytics and predictive capabilities.

Blue Cross and Blue Shield will launch a health insurance exchange this summer that will support employers’ efforts to help retirees transition from group health benefits to individual Medicare coverage that starts Jan. 1, 2016.

Shifting from fee-for-service to value-based pay depends heavily on five factors.

Data, quality, specialty drug costs and social determinants of health are the pain points that are keeping executives at nonprofit safety net health plans up at night.

People in states that expanded Medicaid under the Affordable Care Act are far more likely to be newly identified with diabetes than in non-expansion states, according to a study published online in Diabetes Care.