Authors


Julie Malida

Latest:

BLOG: Look beyond pharmacy claims to detect fraud

Advanced analytic solutions are being used to detect improper payments in pharmacy claims.


Bob Pieper

Latest:

CMS eyes bundled payment pilot for specialist physicians

The initiative would expand Medicare’s present Bundled Payments for Care Improvement (BPCI) program


Perry Cohen, PharmD, FAMCP

Latest:

Dysfunction at the FDA, NIH, Elsewhere | Predictions for 2025

Predictions for this year from Perry Cohen, Pharm.D., CEO of the TPG Family of Companies and Managed Healthcare Executive editorial advisory board member.


Patrick Horine

Latest:

How Current Accreditation Approaches Impact Reduction of Hospital Readmissions

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.


Eladio Alvarez

Latest:

Five Tech Predictions for Healthcare in 2018

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.


Scott McFarland

Latest:

Three Essentials Providers Need for Risk-Based Contracts

These core elements make up a collaborative “provider enablement” strategy to break down resistance to value-based care.


Janice W. Young

Latest:

Take a three-pronged approach to defined contribution

Consumer focus is an enterprisewide strategy


Alison Greco, PsyD

Latest:

Four Ways Health Plans can Guide Members to Wise Choices

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.


Harish Pai

Latest:

Four Ways to Leverage Artificial Intelligence

Here's how artificial intelligence improves the healthcare ecosystem.



Mark Nathan

Latest:

Five Steps to Improve Healthcare Consumer Experience

To build trust, health insurers need to demonstrate their value to customers. That means offering a convenient, satisfying customer experience. Here’s how.


John Schieszer, MA

Latest:

News You Should Know: 3 Takeaways from Top Managed Care Articles June

Have two minutes? Listen to this quick podcast for critical takeaways from three of our top articles.


Joanne Mai, MPH

Latest:

New Reimbursement May Level Playing Field for Biosimilars

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.


Andrew Cournoyer, RPh, MBA

Latest:

New Reimbursement May Level Playing Field for Biosimilars

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.


Ankita Chowdhury, PhD

Latest:

New Reimbursement May Level Playing Field for Biosimilars

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.


Hoala Greevy

Latest:

4 Ways You Can Keep PHI Secure

What are the best ways for healthcare executives to keep protected health information secure? Here are some tips.


Michelle Histand

Latest:

Innovation Isn’t So Hard After All

What a movie can teach you about innovation in your organization.


David Parker, PhD

Latest:

CMS to Cover Next-Gen Sequencing for Cancer: Implications 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?


Karen Richards

Latest:

CMS to Cover Next-Gen Sequencing for Cancer: Implications 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?


Shelley Riser, RN, BSN, MSHA, Geneia Vice President, Consulting Services and Clinical Innovation

Latest:

Closing Care Gaps: Chart Chasing Has Become Obsolete

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.


Nicolle D’Onofrio

Latest:

Top 3 Problems with Healthcare Organizations’ Content Strategies

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.


Paul Schrimpf

Latest:

Top 3 Problems with Healthcare Organizations’ Content Strategies

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.


Kevin Mehta

Latest:

A Look at the Two Sides of Bundled Payments

Why some health plans have mixed feelings on adopting bundled payments and what it can become.


John Booher

Latest:

Top 3 Opportunities for Artificial Intelligence in Healthcare

Rapid advances in the availability of big data and in machine learning offer significant opportunities to improve the healthcare system.


Jack Towsley

Latest:

Three Areas That Benefit From Provider-Led Health Plans

Starting or strengthening a provider-led health plan leads to true integration, resulting in quality care.


Steven Sullivan

Latest:

How Healthcare Organizations are Rethinking Executive Compensation

How one public trust healthcare system overhauled its overall compensation program and successfully transformed its financial operations.


Sheela Ramamurthy

Latest:

Top 3 Capabilities Health Execs Need in Care Management Technology

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.



David Henka

Latest:

How Pharma Reference Pricing Can Contain Healthcare Costs

Reference pricing models are emerging as increasingly popular approaches for lowering drug costs.


Bruce A. Johnson, Janice A. Anderson, Marissa R. Urban, Neal D. Shah, and Gabriel Scott

Latest:

CMS Reevaluates Stark Law in Response to Value-Based Care Initiatives

An RFI presents an important opportunity for the healthcare industry to educate CMS on current experiences and challenges.

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