Authors
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Key Takeaways Following MAJIC-PVGabriela Hobbs, MD, and Timothy Mok, PharmD, BCPS, BCOP, close the discussion with key takeaways for payers to consider related to ruxolitinib and insights on future research.
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Perspectives and Future Directions in Biosimilar Health Care DeliveryA panelist discusses how managing biosimilars requires close collaboration between payers and health systems to optimize patient care and cost savings, while sharing insights about program implementation challenges across different care settings and emphasizing the importance of robust operational frameworks.
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Patient-First Practices: A Strategic Approach to International HealthcareA substantial reduction in claim costs can be persuasive and attention-grabbing, but without assurances of continuity of care and proper clinical oversight, the ultimate goal of positive patient health outcomes can be elusive — and costly.
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Leaning into Digitization to Improve Patient Satisfaction and Optimize OperationsAs patients become discerning consumers of healthcare, providers are focused on implementing processes and technologies that enhance the entire experience, from care delivery through to payment obligations.
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Unlocking Better Health: Why Health Literacy Needs a Digital RevolutionArtificial intelligence stands out as a particularly promising solution to the challenges of improving health literacy.
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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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Ghost Network BustersAudits and AI might help deal with the problem of woefully inaccurate provider directories supplied by insurers to their members.
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2023 PFS Final Rule: 8 Key Strategies That Boost New ACOs, Increase Healthcare AccessThe 2023 CMS Physician Fee Schedule Final Rule has been released, and in a mere 3,304 pages, CMS has largely finalized its proposals from over the summer.
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What the Trump Presidency Will Mean for U.S. Healthcare and Managed CareThis webinar on "What the Trump Presidency Will Mean for U.S. Healthcare and Managed Care" includes panelists Lindsay Greenleaf, J.D., MBA; Ryann Hill, M.P.H. and Patrick Cooney, discussing possible changes to healthcare policies and programs under the Trump administration, including the future of the Inflation Reduction and Affordable Care Acts, PBM reform and Medicare Advantage.
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What Shifting U.S. Demographics Mean for Health PlansThe 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.
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4 Tactics to Address Uptick in CARES-Related Billing and Other Claims DenialsWith the uptick in claims denials, which have increased sharply due to CARES-related provisions, the onus is on providers to directly address a problem that’s only going to get worse as we continue to work our way through the COVID-19 pandemic. Recommended is a 4-pronged approach for providers to address this.
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Needed: A Prevention Strategy To Stop Amputations Among Minority Populations Living With Complex DiabetesLower limb amputations are devastating for people living with diabetes, particularly for Black Americans facing poor access to comprehensive care. A coordinated, data-driven national prevention strategy is the only way to curb this growing epidemic for all at-risk populations.
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To Avoid Falling Off the Telehealth Cliff, Education Needs to be a PriorityThe resulting spike in telehealth use exceeded expectations, with an 11,718% increase in remote Medicare visits between March and April 2020.
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24/7 Nurse Triage vs AI: Enhancing Ambulatory Care, Shielding Against Under-TriageThe need for tools that effectively route patients to the right care at the right time has intensified. But relying only on a tech-enabled approach heightens the potential for missed human connections.
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Female Carriers of X-Linked Retinal Diseases Advocate for Gene Therapy AccessMany carriers reported feelings of concern, anxiousness, and guilt for passing the X-linked inherited retinal disease to their children—and 78% of respondents in a new study believe that carriers should have access to gene therapy options.
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Minimize Downtime, Maximize Uptime: Key Network Strategies for Healthcare Facilities to EmployData revealed that just one minute of downtime costs the average business $5,600.
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Tailoring Diabetes Quality Measures for Diverse Patient PopulationsAn expert in diabetes care discusses tailoring diabetes quality measures to different types of patient populations.
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How a Collaborative Approach to Health-at-Home Care Creates ValueBy customizing collaborative models of at-home care to the health needs of the community and the business needs of key stakeholders, organizations can develop an innovative model that achieves mutual goals while strengthening health outcomes, access, and satisfaction.
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Profits of Publicly Traded Health Plans Surge Amid Requests for Higher RatesAmid 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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CMS’s RADV Strategy Will Reverberate Throughout Health Plan OperationsTo prepare for CMS’ new risk adjustment data validation (RADV) strategy, Medicare Advantage plans must take a coordinated, organization-wide approach.
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Drug Discount Programs Poised to Change with New Tech, Pharma Execs Survey FindsIt is somewhat mind-boggling in 2024 that more than one-third of pharma organizations still rely on manual entry of data into Excel spreadsheets to track duplicate discounts that can cost millions of dollars a year in lost revenue
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Common Challenges in Health Systems of Great Britain and the United States Offer Valuable Learning OpportunitiesThe National Health Service provides some lessons — both good and bad — around models of coverage expansion.
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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.
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Streamlining Medicare Advantage Enrollment is Key for Health Plans to Thrive During SurgeAs soon as next year, enrollment in Medicare Advantage plans are expected to exceed 50% of the entire Medicare eligible population. For the first time ever, the majority of Medicare beneficiaries will receive health benefits delivered by a private health plan, rather than through traditional, fee-for-service Medicare.
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Adapting EHRs for the 21st CenturyThere is a great deal of speculation, and apprehension, in the healthcare industry about the 21st Century Cures Act and what it will mean for EHRs and the clinicians who use them.
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Navigating Challenges and Impact on Workflow with New NMIBC Therapies in PracticeAn expert discusses how integrating newer NMIBC therapies faces operational barriers including administration logistics, staff training and formulary restrictions, while solutions require better comparative data, institutional protocols and industry partnerships to overcome unwarranted practice variation.
