Authors



Gary Call

Latest:

Encouraging Evidence-Based Healthcare with Pre-Payment Integrity

Increasing the practice of evidence-based care is vital to improving the quality and efficiency of care in the U.S. To push more providers to adopt evidence-based medicine, we must reward high-quality patient outcomes - not high volumes.





Todd Shryock

Latest:

Study: Reducing Diabetes Drug Costs Improves Health Outcomes

A study from Harvard Pilgrim Health Care Institute also found that patients with diabetes who were enrolled in a value-based medication benefit increased their use of antidiabetic medications.


Heather Bassett, M.D.

Latest:

Three Ways to Alleviate Hospital Staffing Challenges through Technology

Technology can help cut back on unnecessary administrative tasks, improve task efficiency and better preserve staff resources.


Harvey Jenner

Latest:

Maximizing Impact Through Strategic Research Investments That Address Unmet Needs

Patient organizations should focus on how they can be the most effective by leveraging their strengths to uncover new research opportunities.


Stephanie Sabel

Latest:

Best Practices for Communicating OBGYN Services During COVID-19

At a time like this, it is important for providers and health systems to establish an OBGYN communication strategy to ensure existing and prospective patients are aware of the precautions their obstetricians are taking to safely deliver babies and conduct routine appointments for those who are, or plan to become, pregnant.


Peter Wehrwein, Managing Editor

Latest:

Unintended Effects of Caps on Insulin Out-of-Pocket Costs

People with higher incomes and those in health plans with health savings accounts benefit more than others, according to research results published this week in the Annals of Internal Medicine. The research also showed no increase in insulin use,


Patrick Campbell

Latest:

Chances of Developing Gout Are Higher for Patients With IBD

Study links inflammatory bowel disease diagnosis to increased gout risk, with Crohns disease and ulcerative colitis linked to 68% and 38% increases in likelihood of developing gout, respectively, relative to counterparts without IBD.


Thomas E. Fraysse

Latest:

Relaxation of Telemedicine Rules Post-COVID-19 Opens Door to Fraud

For opportunistic fraudsters and medical predators, the relaxation, suspension or outright elimination of restrictions on the use of telehealth technology presents a plethora of opportunities previously unseen.


Maria Turner

Latest:

How Much Will Telehealth Go “Back to the Future” Following the Pandemic?

Prior to the COVID-19 pandemic, telehealth was more of a stretch goal than a reality for most providers despite the seeming prevalence of video conferencing.


Karen Iapoce, RN, MSN, CPHQ, CAPA

Latest:

Medicaid Redetermination Post-PHE: Navigating the Uncertainty

In this opinion piece, Karen shares some of the critical issues related to re-enrolling members subject to Medicaid redetermination and covers some of the most important critical success factors for organizations seeking to optimize their response.



Jennifer Fuller

Latest:

Why COVID-19 Has Put Records Management in the Spotlight for Healthcare Insurers

Although the importance of comprehensive records management programs is not a new phenomenon, over the last few months events surrounding COVID-19 have brought records management into increased focus.


Megan R. Heiden

Latest:

OSHA's COVID-19 Emergency Temporary Standard: What Healthcare Employers Need to Know

OSHA issued new "emergency temporary standards" for healthcare employers that create new rules for personal protective equipment (PPE), isolation in case of contact and other measures designed to protect workers and patients from COVID-19.




Terry S. Weber

Latest:

Time to Bring Clinical Light to Shadowed Women’s Health Issues

The scientific community has the urgent opportunity to produce more research on the proven health benefits of testosterone and other hormones for women.


Cindy Koppen

Latest:

How Innovation in Healthcare Technology Can Help Improve Nursing Culture

Amid the nursing shortage, hospitals can create better working conditions through these three technology solutions.


Hannah Bowlin

Latest:

The Opportunity in CMS’s Price Transparency Rule

The opportunity for health insurers is to implement a well-designed cost estimator tool that goes beyond compliance to the new CMS rule and meets member and health insurer market trends by integrating more quality and cost metrics with an easy-to-use member interface.


Leonard Feld, M.D., Ph.D., M.M.M.

Latest:

Could the Pandemic Put an End to Medical Overtreatment?

COVID-19 pandemic may present an opportunity to hit a reset button on American healthcare that could winnow out unnecessary, wasteful services and prescriptions.


Jeremy Berk

Latest:

CMS Has Changed the Game for Medicare Advantage Reimbursement. Here’s How Plans Can Respond Effectively.

Jeremy Berk, senior vice president of Risk Adjustment Solutions for PopHealthCare and Emcara Health, shares how plans must conduct a detailed analysis of how changes to risk adjustment models impact your plan in order to set an effective go-forward strategy.


Meleah Bridgeford

Latest:

How Will the End of the CMS Submission Deadline Extension Affect Your Risk Adjustment Program?

With the Centers for Medicare & Medicaid Services extension on claims submissions coming to an end in 2024, health plans must separate fact from fiction around proactive risk adjustment to confidently submit claims for accurate reimbursement.


Joe Ganley

Latest:

Let’s Stop Talking About Interoperability and Just Make it Work

Interoperability was theme at the Healthcare Information and Management Systems Society (HIMSS) meeting last week in Chicago. How can all that talk and aspiration be turned into action?


Adam Grossman

Latest:

To Drive Value-Based Healthcare, We Must First Redefine It

The healthcare industry needs to better align with consumers around this notion and their broader perception of what constitutes value.


Gerard Vitti

Latest:

What Shifting U.S. Demographics Mean for Health Plans

The country is becoming more diverse. Health plans need to adapt by making their provider networks as diverse as possible and committing to diversity in their management ranks.


Alisa L. Chestler

Latest:

Reproductive Privacy Rights: Changes Coming for Healthcare Organizations

The Office of Civil Rights published a proposed rule that could have healthcare organizations evaluating their practices surrounding, and interactions with, reproductive healthcare information.


Leah Dillard, B.A.

Latest:

Profits of Publicly Traded Health Plans Surge Amid Requests for Higher Rates

Amid struggling providers, furloughs of essential workers, years of premium increases and record high earnings, for-profit health plans should consider options for directly helping their networks.

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