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Games for health have become serious opportunities for plansHealthcare gaming has made progress in the past year by allowing consumers to engage in health via mobile devices.
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Top Challenges in Managing DiabetesThe leading problems that endocrinologists and educators see from their daily interactions with diabetes patients.
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Commercial Blues plans adopting the CMS do-not-pay list policyIn a move toward accountable care, the Blue Cross and Blue Shield Assn. (BCBSA) has established a policy that denies acute care hospitals reimbursement for certain never events.
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Report: Medical Costs to Rise 7% Next YearThe increase is expected to be somewhat offset by the impact of biosimilars coming to market and more care being provided in outpatient settings.
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Leverage health data gathered from electronic recordsSecondary use of electronic data from claims and clinical sources will drive savings
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FDA prioritizes drug safety, expects industry to be proactiveMore than 4 million annual provider visits, including visits to the ER, can be attributed to adverse drug events
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Michigan’s Medicaid Program Plans to Save Millions By Eliminating PBMsThe state’s desired savings and efficiencies can be realized, but will likely take some effort.
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Opinion: The Best Lesson We Can Learn from the German Healthcare SystemAs President Trump intensifies his battle with German Chancellor Angela Merkel over trade and NATO policies, he should pause to consider the lessons from another German Chancellor-Otto von Bismarck.
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Shifting employees to exchanges provides no real advantageAmong the decisions employers are tackling is whether to keep their group health plans.
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Payment reform redefines provider performance managementA health plan's approach to provider reimbursement is rooted in the need to move from traditional fee-for-service models to a payment model that accounts for providers adhering to best practices.
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Take steps to prepare for insurance exchangesInsurance exchanges will not exist in a vacuum; they will touch every part of the healthcare system and require substantial changes to the way payers do business.
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Review health risk assessment use under new GINA rulesFinancial incentives and penalties are no longer permitted when genetic information is requested on health risk assessments
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Kentucky co-op leverages outreach during open enrollmentNew members likely to have more chronic conditions
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States move forward with unique ACO models for MedicaidEarly efforts by states drive value with Medicaid ACOs, coordinated care.
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Elevating to ICD-10: It may be a great fit for healthcareThe World Health Organization's latest version of the International Classification of Diseases and Related Health Problems (ICD) will bring "the good, the bad, and the ugly" for nearly all who use this classification system. However, the biggest asset is that the latest version is much more detailed and organized than ICD-9.
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Elevating to ICD-10: It may be a great fit for healthcareThe World Health Organization's latest version of the International Classification of Diseases and Related Health Problems (ICD) will bring "the good, the bad, and the ugly" for nearly all who use this classification system. However, the biggest asset is that the latest version is much more detailed and organized than ICD-9.
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Elevating to ICD-10: It may be a great fit for healthcareThe World Health Organization's latest version of the International Classification of Diseases and Related Health Problems (ICD) will bring "the good, the bad, and the ugly" for nearly all who use this classification system. However, the biggest asset is that the latest version is much more detailed and organized than ICD-9.
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Exchanges would need local participationState-level insurance exchanges are more likely to thrive in the market by taking advantage of integration
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Green initiatives growing among healthcare facilitiesReducing water and electricity use can produce immediate savings for hospitals while recycling efforts pay off in the longrun
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How Artificial Intelligence Can Help Health Plans Manage Chronic ConditionsManaging members with chronic conditions is a complex, costly challenge for health plans. Using AI to combine real-time patient data and guideline-directed medical therapy can help.
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Consumer-driven pharmacy plans must focus on compliance and safetyA recent survey by the Employee Benefit Research Institute found that 70% of those enrolled in consumer-directed health plans (CDHP) say that they consider costs when deciding to see a doctor or filling a prescription as compared with fewer than 40% of those in a comprehensive plan. However, the survey also found that CDHP enrollees were twice as likely to avoid, skip or delay healthcare services.
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Consumers unwilling to change behavior to lower care costsWhile patients may complain about the rising cost of their healthcare, few of them appear willing to do much about it, according to a new survey.
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Begin obesity programs in early childhoodCustomize your obesity program for children, beginning as early as preschool
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Medicaid beneficiaries require improved case managementMedicaid beneficiaries require care management and case management services because there's a higher concentration of comorbid conditions and other significant issues in this population
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EHRs not sufficient for data liquidityAn EHR is one technology within the health IT portfolio, which also includes e-prescribing, clinical decision support, messaging and alerting, telehealth, consumer health information portals and other technologies
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EHRs not sufficient for data liquidityAn EHR is one technology within the health IT portfolio, which also includes e-prescribing, clinical decision support, messaging and alerting, telehealth, consumer health information portals and other technologies
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Use of telehealth could save billionsIf passed, the Medicare Telehealth Enhancement Act introduced earlier this year promises to greatly expand telehealth programs
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EHRs not sufficient for data liquidityAn EHR is one technology within the health IT portfolio, which also includes e-prescribing, clinical decision support, messaging and alerting, telehealth, consumer health information portals and other technologies
