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Why Timing Matters When It Comes to PBM ContractingPlan sponsors should begin evaluation of PBM performance at least a year before the contract expires, say lawyers with expertise in PBM contracting.
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To Proactively Address SDOH, the ‘Top of Funnel’ is CriticalWe can identify and engage the right people. But to make a real difference in any community, a managed care organization, government agency or healthcare system needs to have a robust list/dataset of its population so the tools, processes and individuals that come after can do the work to identify and engage members with the highest needs.
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What’s Next in Healthcare Mergers & AcquisitionsLast year was a record setting year in worldwide merger and acquisition activity across multiple industries, and healthcare was a big part of that.
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Addressing Ransomware in HealthcareThere have been an alarming increase of ransomware attacks on healthcare systems in 2021—with more than 65 reported ransomware attacks on healthcare organizations in the third quarter alone and two-thirds of organization reporting that they had been targeted by ransomware strikes—a trend that is likely to continue in 2022.
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Reproductive Privacy Rights: Changes Coming for Healthcare OrganizationsThe Office of Civil Rights published a proposed rule that could have healthcare organizations evaluating their practices surrounding, and interactions with, reproductive healthcare information.
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DOJ Issues Important Updates to Evaluation of Corporate Compliance GuidanceA strong, up-to-date compliance program should be part of a healthcare company's risk management strategy.
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Empowering the Next Generation of Nurse LeadersHealthcare organizations must encourage anyone in need to explore the mental health and wellness resources available at their institution.
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As the COVID-19 Pandemic Drives Record Telehealth Use, What’s Your Long-Term Plan?Preparing for a future that includes telehealth means considering revenue streams, ROI, facility planning and other factors.
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Addressing Ransomware in HealthcareThere have been an alarming increase of ransomware attacks on healthcare systems in 2021—with more than 65 reported ransomware attacks on healthcare organizations in the third quarter alone and two-thirds of organization reporting that they had been targeted by ransomware strikes—a trend that is likely to continue in 2022.
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Zeposia, Vumerity Tie on Efficacy but Zeposia Has Superior Safety ProfileFindings presented at the 2023 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) were the first to compare the two drugs for relapsing-remitting multiple sclerosis.
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How AI Can Help Payers Streamline Prior Authorizations to Save Time, Improve Member CareMany prior authorizations requests still come in by fax. Natural language processing and artificial intelligence can extract and use information from faxes.
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The Urgent Case for Proactive Behavioral HealthcareThe healthcare system is facing an onslaught of patients with new and worsening conditions due the COVID-19 pandemic, but it is nowhere near ready to accommodate them.
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How Payers Can Weather the COVID-19 Storm – and Its AftermathCOVID-19 has revealed the power and value of data analytics as claims have gyrated in unprecedented ways.
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5 Tips for Health Plans to Improve Race and Ethnicity DataEquity is a central part of healthcare quality, but health plans often lack information on individual members’ race and ethnicity, making assessing and improving health outcomes challenging.
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An Urgent Call to Reduce and Reuse Hospital Supplies for Stronger Financial, Environmental and Clinical SustainabilityNow is the time to take serious action to reform wasteful hospital practices and strengthen the healthcare supply chain. The high cost of American healthcare has topped headlines for years.
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Why 2021 Patient Experience Will be Tied to Telehealth SuccessHow consumers feel about their virtual care encounters will influence everything from CAHPS surveys to compensation beyond the pandemic.
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The Oncology Care Model Provides a Framework for the New Enhancing Oncology ModelThe new model starts in July 2023. Practices will be required to take on two-sided risk right from the start.
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The Keys to Effective Hybrid Care: Simplify, Streamline and AdaptIn the post-pandemic future, we will likely see that hybrid patient care models are the norm. As hospitals and health systems plan for this shift, they’ll need to consider two critical factors.
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Study Examines the Correlation Between COVID-19 Vaccination and Vitiligo OnsetA recent study presents a unique case of sudden-onset vitiligo following the COVID-19 vaccination, along with a systematic review of existing literature to shed light on the potential link between vaccination and vitiligo development.
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A Better Way of Collecting Patient-Reported OutcomesMany healthcare organizations find themselves in arrangements with technology vendors in which patient-reported outcomes measures are handled as an add-on to an existing electronic health records. The better way makes it easier and more convenient for patients to supply information and incentivizes engagement.
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AbbVie Plays Its Ace Cards Against Humira’s DeclineTen biosimilars to Humira are now on the market, but AbbVie’s Skyrizi and Rinvoq are soaking up revenues as Humira’s sales fall off.
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We Need a Data-driven Approach to Vaccine DistributionThe complexity of the phased approach to COVID-19 vaccination will require strategic use of data and communication.
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Access to Cancer Care Improves Racial Disparities in CLL/SLLFuture interventions for improving disparities should be aimed at improving overall access to care for patients with chronic lymphocytic leukemia/small lymphocytic lymphoma.
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COVID-19 Reaffirms: RPM is Wise Investment for Health InsurersSignificant attention has been paid to the recent surge in telehealth. This attention is valid. While usage of telehealth has declined from the initial months of the pandemic, FAIR Health data show that telehealth claim lines had increased more than 2,800% nationally from December 2019 to December 2020.
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Insomnia and its HarmsChronic insomnia has been linked to a variety of mental and physical illnesses. Researchers have found that cognitive behavioral therapy is often effective.
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Considering the Ideal Role for Non-Emergency Medical Transportation in Addressing SDoH in Medicaid and Medicare PopulationsMedicare and Medicaid programs that serve the most-vulnerable Americans facing SDOH barriers can be major facilitators of appropriate non-emergency transportation to non-medical sites. But how do we determine what is appropriate, and what do we know about transportation services to non-medical sites today?
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How Providers Can Add Patient-Generated Health Data to EHRs Without Fueling Clinician BurnoutTo make patient-generated health data work for clinicians, health information technology vendors must effectively integrate this patient-generated data into clinical workflows in a way that helps clinicians do their jobs more efficiently and effectively.
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Shedding Light on Healthcare’s Dark ArtsFrançois de Brantes, a member of the Managed Healthcare Executive ® editorial advisory board and senior partner at High Value Care Incentives Advisory Group LLC, describes what he believes has caused a major inflection point in the management, delivery and payment of U.S. healthcare
