Nearly four in 10 organizations that offer health insurance through state exchanges also operate a Medicaid managed care plan in the same state, offering an opportunity for continuous coverage for low-income consumers.
Health Law & Policy
According to the research firm Gartner, Inc., information technology is subject to a five-phase acceptance cycle: a Technology Trigger, Peak of Inflated Expectations, Trough of Disillusionment, Slope of Enlightenment, and Plateau of Productivity. Even zealous advocates of social media marketing (SMM) admit their craft is currently stuck in the disillusionment phase.
Unlike a traditional formulary, the value-based formulary emphasizes the clinical effectiveness of a drug rather than cost so that if a drug is very effective but expensive, it might still fall on tier one.
From Blue Shield of California's recently-announced purchase of a Medicaid plan to Partners HealthCare's hard-fought effort to fold more hospitals into its Massachusetts health system, the volume of mergers and acquisitions in the healthcare sector has steadily climbed and now exceeds M & A activities in all other U.S. industries. The surge is being fueled by payers and providers seeking new business opportunities in the post-ACA healthcare market, and 2015 is on track to be another record-breaking year.
Envisioning a public health threat, managed care recently notched up its readiness for an Ebola outbreak in the United States. Valuable lessons emerged from the latest effort, adding to the knowledge gleaned from other epidemics, such as the HIV/AIDS and SARS viruses and the bird flu.
Nearly a year after two medical societies released a national consensus statement on the safe prevention of certain C-sections, broad consensus seems to boil down to this: Steps must be taken to lower C-section rates in the U.S., and strong outreach to ob/gyns is critical for success.
Texas, which has almost 1 million residents in the coverage gap, has inquired about Medicaid expansion, while Arizona faces a renewed challenge to its existing expansion program.
The implementation of the Affordable Care Act (ACA) stands to alter the U.S. healthcare system and the role of private insurance.
The industry is challenged by a number of issues in 2015 including cost control, technology threats, and the emerging consumer market.
The launch of the Small Business Health Options (SHOP) marketplace drew 200,000 visitors during the first week of open enrollment.