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CMS’ 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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How Community-Based Gene Therapy Is Changing Treatment and Improving Quality of Life for Patients With BCG-Unresponsive NMIBCAn expert discusses how community-based gene therapy administration has broadened treatment options for patients with BCG-unresponsive NMIBC by providing easier logistics compared with complex chemotherapy regimens, ultimately expanding bladder-sparing approaches and avoiding radical cystectomy in younger, sexually active patients.
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Headaches Behind the Eyes – Triggers, Treatments and How to Prevent ThemAcross the world, almost everyone has experienced a bad headache and knows the unpleasant symptoms that can come with it. Many have also faced migraines, which can cause dizziness, nausea and stomach pain - as well as impacting your vision.
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Advancing Care Coordination, Equity and AI Integration | Predictions for 2025A prediction for 2025 from Laura Kohlhagen, M.D., MBA, chief medical officer, of Altera Digital Health.
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CDC’s Proposed Opioid Prescribing Guideline: Does it Fall Short on Drug Testing?Last month, the Centers for Disease Control and Prevention shared a draft update to its Clinical Practice Guideline for Prescribing Opioids. The proposed revision comes as the nation’s overdose death rate reaches an all-time high, fueled largely by the economic and psychological strains and lack of healthcare access caused by COVID-19.
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Healthcare Needs Tech Workers — But Tech Workers Also Need the Healthcare IndustryPandemic-triggered changes in the healthcare industry have required hospitals, clinics, and other healthcare facilities to scale up their technology operations, resulting in high demand for tech experts.
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Advancing Diagnostic Precision in Type 1 DiabetesPanelists discuss how autoantibody testing has high diagnostic accuracy with nearly 100% conversion to hyperglycemia when two or more antibodies are present, though timing of testing is crucial and retesting may be necessary since antibody levels can fluctuate over time.
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Tackling LGBTQ+ Bias in HealthcareThe chief medical officer for Grand Rounds Health and Doctor on Demand says the healthcare industry needs to be committed to creating equitable and inclusive environments.
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Don’t Panic. Or Don’t Get Your Hopes Up. The FTC’s Proposed Rule Banning Non-competes May or May Not Go Into EffectEven if the Federal Trade Commission were to ban noncompetes, legal challenges to block the ban are nearly certain.
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Bringing Real World Evidence into the Care SettingReal-world evidence (RWE) has the potential to be a transformative tool for healthcare providers to enhance the care they deliver to patients.
