Authors


Karen Vloedman

Latest:

How Physician-Led, In-Home Care Can Save Lives During the Pandemic and Beyond

Dr. Karen Vloedman shares her learnings that will help inform best practices to assist payers and provider groups when preparing for and navigating the CoVID-19 pandemic.


Cindy Gaines, M.S.N., RN

Latest:

With Nurse Burnout at an All-Time High, Offer Tangible Relief

Technology is the key to giving nurses more time to focus on patients.


Richard Mark Kirkner

Latest:

TAVR Equal to Surgery in Low-Risk Patients with Severe Aortic Stenosis | ACC 2025

Researchers found that at five years, patients with severe aortic stenosis who were treated with either TAVR or surgery had comparable rates of all-cause mortality or disabling stroke.


John Carey

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.


Kim Perry

Latest:

AI Soups up Payer Operations | Predictions for 2025

Kim Perry, chief growth officer of Emtelligent, shares her prediction for 2025.


Andrew Perlstein

Latest:

Ensure You Partner With Problem Solvers, Not Problem Finders

What’s more valuable than the ability to identify problems within your business plan or strategy? The ability to find solutions to those problems before they arise.




Timothy Mok, PharmD, BCPS, BCOP

Latest:

Key Takeaways Following MAJIC-PV

Gabriela 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.


Eric Tichy, PharmD, MBA, BCPS, FCCP, FAST

Latest:

Perspectives and Future Directions in Biosimilar Health Care Delivery

A 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.


Mike Agostino, R.Ph.

Latest:

Patient-First Practices: A Strategic Approach to International Healthcare

A 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.


Lauren Ruane

Latest:

Leaning into Digitization to Improve Patient Satisfaction and Optimize Operations

As 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.


Alison Lyne

Latest:

Unlocking Better Health: Why Health Literacy Needs a Digital Revolution

Artificial intelligence stands out as a particularly promising solution to the challenges of improving health literacy.



Alex Iftimie

Latest:

Addressing Ransomware in Healthcare

There 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.



Gianna Melillo

Latest:

Ghost Network Busters

Audits and AI might help deal with the problem of woefully inaccurate provider directories supplied by insurers to their members.


Dave Halpert

Latest:

2023 PFS Final Rule: 8 Key Strategies That Boost New ACOs, Increase Healthcare Access

The 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.


Lindsay Bealor Greenleaf, JD, MBA

Latest:

What the Trump Presidency Will Mean for U.S. Healthcare and Managed Care

This 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.


Loida Olmeda Dunham

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.


John Mollica

Latest:

4 Tactics to Address Uptick in CARES-Related Billing and Other Claims Denials

With 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.


Jon Bloom, M.D.

Latest:

Needed: A Prevention Strategy To Stop Amputations Among Minority Populations Living With Complex Diabetes

Lower 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.


Mandy Bell

Latest:

To Avoid Falling Off the Telehealth Cliff, Education Needs to be a Priority

The resulting spike in telehealth use exceeded expectations, with an 11,718% increase in remote Medicare visits between March and April 2020.


Dominique Wells, MSN, RN

Latest:

24/7 Nurse Triage vs AI: Enhancing Ambulatory Care, Shielding Against Under-Triage

The 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.


Chelsie Derman

Latest:

Female Carriers of X-Linked Retinal Diseases Advocate for Gene Therapy Access

Many 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.


Greg Davis

Latest:

Minimize Downtime, Maximize Uptime: Key Network Strategies for Healthcare Facilities to Employ

Data revealed that just one minute of downtime costs the average business $5,600.


Sean M. Oser, MD, MPH

Latest:

Tailoring Diabetes Quality Measures for Diverse Patient Populations

An expert in diabetes care discusses tailoring diabetes quality measures to different types of patient populations.


Cheryl Dalton-Norman, MBA, BSN, RN

Latest:

How a Collaborative Approach to Health-at-Home Care Creates Value

By 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.



Kevin Van Dyke, M.P.P.

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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