Hospitals & Providers

Explore how using support tools can prevent treatment overutilization.

Adding non-opioid postsurgical options to hospital formularies should be a top consideration.

Mental health advocate Patrick J. Kennedy talks to Managed Healthcare Executive about reform, mental health equity, and how payers can help integrate care in mental health.

A Trump administration is expected to have far-reaching impacts on healthcare. Here are nine changes to keep on your radar.

Medicare plans must understand the impact of CMS rule change to be prepared for risk adjustment in 2017. Here are 10 tips to better manage the risk adjustment process.

Study: ACOs can be part of the structure to improve outcomes in children with medical complexity.

Humana and Oak Street Health share the challenges and opportunities of moving away from the fee-for-service model to value-based care.

The 21st Century Cures Act, a landmark medical research bill, offers healthcare executives a promising future.

Experts share their ideas on how President-elect Trump could change the single largest source of insurance in the country.

Results from Managed Healthcare Executive’s annual State of the Industry Survey reveal which issues will hit managed healthcare hardest in 2017.

President-elect Trump named Tom Price and Seema Verma to lead HHS and CMS, respectively. Here’s what you should know about them.

CMS is adding, dropping, and expanding payment rules

Hospitals and health systems that treat some of the country’s most vulnerable populations face complex challenges when working to improve population health.

Telephonic and personalized diabetes self-education programs which fit into patient’s busy lives will make a greater impact than in-person classes only.

In this Q&A, a physician and lymphoma expert discusses treatment advances and promising signs for the future.

Novel immunotherapy treatments are showing promise for patients with acute lymphoblastic leukemia (ALL), but they can trigger cytokine release syndrome.

Joint ventures are gaining steam as health plans and providers look for new ways to work together.

Two experts discuss top-of-mind women’s healthcare issues in managed care.

From “all-in-one” healthcare appointments to coordinating women’s care for convenience, here’s how providers and researchers say plans and providers can prioritize

Here’s how one non-profit health plan harnessed the power of medical and pharmacy data to rein in drug costs.

As fee-for-service rapidly transforms into value-based care, the industry must improve member engagement and outcomes by using targeted care management interventions that help deliver bottom-line results across a broader spectrum of the population.

The path to bundled payment success can be daunting. Here’s three universal concepts that will promote success under the various CMS models.

Rise in use of outpatient care and professional services contributed to quicker growth in spending for the privately insured over previous years.

CMS announced changes to how Medicare pays for primary care. Here’s 5 things to consider.

: Remembering to engage in healthy behavior can often slip to the bottom of our list of priorities. In a world where we need to be reminded and motivated to be the healthiest version of ourselves, the right nudges at the right time can help us get there.

Humana’s value-based reimbursement model with physicians has helped to improve care quality and health outcomes for its Medicare Advantage (MA) program members.

Here’s a three-pronged approach to improve adherence program efficiency that leverages predictive data analytics, hospital on-site pharmacies and post discharge follow-up evaluation to achieve real, measurable results.

By addressing the root problem of obesity with structured programs, providers can help patients lose weight and very possibly avoid expensive chronic illnesses as a result. Employers and payers should incentivize healthy weight by paying for obesity care and treatment, potentially reaping substantial savings in the long term.

Many aspects of the ACA have been assimilated into the healthcare system. Will a Trump administration undo them?

The results of Geneia’s year-long study – a savings of $8,375 per patient and a slowing of disease progression – demonstrate that remote patient monitoring is a wise investment for payers.