Fighting for Coverage
More consumers are purchasing short-term limited duration insurance plans-which will likely have long-lasting effects to consumers and the insurance market as a whole.
ACA in Limbo After New Individual Mandate Ruling
A new ruling on the ACA adds more uncertainty about the law’s future.
Reimbursement Remains a Barrier to Digital Health Adoption
A recent study suggests healthcare organizations see reimbursement concerns-as well as differences in business culture – as roadblocks to embracing digital health partnerships.
Considering Social Determinants of Health in Reimbursement
Could per-person adjustments to Medicaid payments help better address social inequalities that affect overall health?
Continued Uncertainty Regarding Hospital Pricing Transparency
CMS has put forth pricing transparency provisions for both hospitals and insurers – but what will they really mean for healthcare?
Strategies to Help Reduce Hospital Readmissions for Cancer
As more healthcare organizations look to curb hospital readmission rates, they are taking a hard look at one of medicine’s most complex conditions-cancer.
Missed Savings from Mergers and Acquisitions
Healthcare is still undergoing a large number of M&As – but are they offering the kind of value originally sought? New research suggests not.
The Rise of Specialty Spend
How can payers appropriately plan and manage benefit coverage with so many expensive specialty drugs coming down the pipeline?
Preparing for Biosimilar Uptake
As more biosimilar drugs gain approval, managed care organizations need to consider how to best utilize them for optimal savings.
Embracing Value-Based Outcomes Management
As more of the healthcare industry moves to value-based contracts, it is imperative that managed care organizations can successfully measure outcomes.
Legislating Medicare and Medicaid Drug Plans
With the proposed rebate rule now withdrawn, what will Congress do to help curb drug spend?
A Brave New World of Health Technology and Digital Therapeutics
As digital health and therapeutic capabilities continue to grow, it is vital that managed care organizations keep one eye toward the future.
Specialty Medications and Managed Care Pharmacy
At AMCP Nexus 2019, experts weigh in on new and emerging specialty medications.
Physician Consolidation Leads to Higher Healthcare Costs
As more healthcare organizations and private equity firms purchase or invest in physician groups, costs for consumers rise.
Set the Data Free
A new survey suggests that healthcare organizations are missing the vital claims data they need to fully embrace risk-based payment arrangements.
Telehealth Reimbursement Moves Toward Greater Parity
A new survey suggests that more states-and payer organizations-are expanding telehealth coverage.
Expanding the Reach of Health Reimbursement Arrangements
Will a new final rule expanding the use of health reimbursement arrangements shake up the markets as much as some fear?
Finding-and Keeping-Good Employees
With a rapidly-growing employment environment, how can healthcare orgs best recruit and retain the right employees?
Uniting Determinants and Data for Population Health
How can healthcare organizations better overcome the challenges involved with integrating social determinants of health data into their population health initiatives?
New Payer-Technology Partnerships Could Be Telehealth’s Future
Why the introduction of telehealth kiosks in employers is part of a trend of increased patient visibility.
The Rise of Health Care Sharing Ministries
The number of members joining Health Care Sharing Ministries are swelling. One reason may be that consumers don’t understand such organizations don’t provide actual health insurance.
Watching the Drug Pipeline
With a record number of innovative drugs queued for FDA approval, managed healthcare executives have an eye toward innovative new products that tackle difficult conditions.
Contemplating the Future of List Prices
With a country-wide focus on reducing the cost of prescription drugs, managed healthcare executives make their forecasts concerning the future of list prices.
Tackling True Cost Transparency in Healthcare
The Trump Administration is calling for better price transparency to help control healthcare costs-but is publishing list prices enough?
Designing for High Medication Adherence
How the right benefit design can help increase patient engagement and adherence to key maintenance therapies.
Balancing the Costs of Rare Disease Treatment
The rare disease community struggles to balance care with costs.
Studies Suggest ACA Helps with Healthcare Disparities
With the future of the ACA still in question, new studies suggest its provision for Medicaid expansion has helped to correct healthcare disparities in cancer.
The Biggest Ways to Reduce Specialty Drug Costs
Managed Healthcare Executive’s Managed Care Pharmacy Survey identifies different ways specialty pharmacy stakeholders believe they can reduce industry costs moving forward.
The Ripple Effects of High-Priced Drugs
How will payers, providers, and patients respond when a $2 million drug drops into the market?
Hospitals Charge Employer Plans Double What Medicare Pays
A new RAND study uncovers significant differences between healthcare costs paid by privately insured patients and those paid out by Medicare.
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