Advanced analytic solutions are being used to detect improper payments in pharmacy claims.
The initiative would expand Medicare’s present Bundled Payments for Care Improvement (BPCI) program
Predictions for this year from Perry Cohen, Pharm.D., CEO of the TPG Family of Companies and Managed Healthcare Executive editorial advisory board member.
Hospitals are always looking for ways to reduce readmission rates. They may have an unusual ally in a quality control system originally developed in Europe for the manufacturing sector. Read more about it.
In the year ahead, we can expect to see an insurgence in technology solutions that address patient engagement, data, and security throughout the healthcare system.
These core elements make up a collaborative “provider enablement” strategy to break down resistance to value-based care.
Consumer focus is an enterprisewide strategy
For all health plans, increasing complexity requires rethinking the presentation of options to members. Choice design, stepped information reveal, high quality, and timely communication, are keys to providing members a helpful and trustworthy healthcare GPS.
Here's how artificial intelligence improves the healthcare ecosystem.
This type of focused approach incorporates four key steps.
To build trust, health insurers need to demonstrate their value to customers. That means offering a convenient, satisfying customer experience. Here’s how.
Have two minutes? Listen to this quick podcast for critical takeaways from three of our top articles.
The new Bipartisan Budget Act of 2018 (to be in effect on January 2019) institute new reimbursement guidelines for biosimilars under the Medicare coverage gap discount program that remove disincentives for biosimilar uptake and level the playing field for the future market place.
The new Bipartisan Budget Act of 2018 (to be in effect on January 2019) institute new reimbursement guidelines for biosimilars under the Medicare coverage gap discount program that remove disincentives for biosimilar uptake and level the playing field for the future market place.
The new Bipartisan Budget Act of 2018 (to be in effect on January 2019) institute new reimbursement guidelines for biosimilars under the Medicare coverage gap discount program that remove disincentives for biosimilar uptake and level the playing field for the future market place.
What are the best ways for healthcare executives to keep protected health information secure? Here are some tips.
What a movie can teach you about innovation in your organization.
In a decision reached through the joint FDA/CMS Parallel Review process, CMS has granted national Medicare coverage to next-generation sequencing tests approved or cleared by the FDA as companion diagnostics for cancer therapies. This is clearly a win for Medicare beneficiaries and some NGS test providers-but is it also good news for MCOs?
In a decision reached through the joint FDA/CMS Parallel Review process, CMS has granted national Medicare coverage to next-generation sequencing tests approved or cleared by the FDA as companion diagnostics for cancer therapies. This is clearly a win for Medicare beneficiaries and some NGS test providers-but is it also good news for MCOs?
For far too long, chart chasing was the best method health plans had to improve HEDIS® measures and Medicare Star ratings. Now, there is a better way.
Virtually all healthcare leaders recognize the value of content creation, yet the use of a well-defined content strategy is rare. Here’s how to get yours.
Virtually all healthcare leaders recognize the value of content creation, yet the use of a well-defined content strategy is rare. Here’s how to get yours.
Why some health plans have mixed feelings on adopting bundled payments and what it can become.
Rapid advances in the availability of big data and in machine learning offer significant opportunities to improve the healthcare system.
Starting or strengthening a provider-led health plan leads to true integration, resulting in quality care.
How one public trust healthcare system overhauled its overall compensation program and successfully transformed its financial operations.
The right technology will enable increased population health efficiencies while simultaneously reducing the resource burden associated with managing that effort. Here are three specific capabilities to look for.
Reference pricing models are emerging as increasingly popular approaches for lowering drug costs.
An RFI presents an important opportunity for the healthcare industry to educate CMS on current experiences and challenges.