Authors


Meggie Hotard

Latest:

Why COVID-19 Has Put Records Management in the Spotlight for Healthcare Insurers

Although the importance of comprehensive records management programs is not a new phenomenon, over the last few months events surrounding COVID-19 have brought records management into increased focus.


Rajeev Ronanki

Latest:

3 Approaches to Creating a Connected Care Future

By integrating capabilities and services, we can create health experiences that are much more than the sum of their parts


Harris Meyer

Latest:

Medicaid Programs Start to Embrace Respite Care for Unhoused

Various groups, clinics and organizations have set up places for people without housing to recover from an injury, surgery and serious illness.


Alicia Warnock,M.D.

Latest:

Overcoming Patient Barriers to Chronic Disease Management

Healthcare professionals need to make patients the primary decision-makers in their own care and actively support their efforts to achieve their care goals.


Lindsey Mulrooney

Latest:

It’s Not Just COVID. There’s Also Long Flu and Pneumonia

Epic research suggests that like COVID-19, flu and other viral pneumonias can result in long-term symptoms like fatigue and brain fog. Why that might be is an open question.


Kristin Ficery

Latest:

Healthcare’s Time is Now to Take Operations Virtual

Kristin Ficery, who leads Accenture’s North America Health, discusses recent Accenture research that discovered since the onset of COVID-19, 60% of patients want to use technology more for their healthcare. And nine out of 10 patients said quality of care was “as good or better” than before COVID-19.


Erin Rutzler

Latest:

Going on Offense Against Fraud, Waste and Abuse in Behavioral Telehealth: 3 Key Actions

Telehealth, especially for behavioral health, has created new opportunities for dishonest individuals to file fraudulent claims. Health plans can take steps to stop the fraud before it happens.



Mike Brett, M.D.

Latest:

Accurate, Specific and Comprehensive Documentation Moves the Needle in Value-based Care

Proper documentation and coding provide better patient care and help plans optimize revenue.


Mike Lamb

Latest:

Patient Engagement: Access is the Future of Healthcare

The pandemic has brought patient self-service to the fore.


Karen Schulte

Latest:

Polypharmacy and the Pivotal Role of the Payer

A SCAN Health Plan "deprescribing" program is working to identify unnecessary prescriptions. In 2023, the program resulted in an estimated $2 million in savings from avoided fractures, falls, visits to the emergency room and other adverse drug events.


David Ramirez, MD

Latest:

The Urgent Case for Proactive Behavioral Healthcare

The healthcare system is facing an onslaught of patients with new and worsening conditions due the COVID-19 pandemic, but it is nowhere near ready to accommodate them.



Anna-Maria Hoffmann-Vold, M.D., Ph.D.

Latest:

Diagnosing PPF and the Importance of Early Detection

Anna-Maria Hoffmann-Vold, M.D., Ph.D., discusses how progressive pulmonary fibrosis is diagnosed in clinical practice, the barriers hindering early diagnosis, strategies to overcome these challenges and the critical role of early detection and intervention in improving patient outcomes and reducing long-term healthcare costs.


Aron Tendler, M.D., CBSM

Latest:

How COVID-19 Has Revealed Cracks in the Mental Health Support System for Healthcare Workers

Managers can help by removing any stigma against seeking help and providing access to support groups and professional services.



Al Fasola

Latest:

The Well-being Measurement Problem

Surveys are important, but respondents may hide their true thoughts and feelings.


Adam E. Block, Ph.D.

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.


Scott Palmer

Latest:

Key Takeaways for Managed Care Organizations as No Surprises Act Goes Into Effect

The No Surprises Act is scheduled to go into effect in January. The law will require providers to provide patients with details of the new balance billing requirements, any state-level limitations or prohibitions in the state of service, and the dispute resolution process.



Hannah Clarke

Latest:

Potential Urology Drug Savings Through Mark Cuban Drug Company

The greatest savings are seen for 90-tablet prescriptions.


Mike Szczesny

Latest:

Transforming Healthcare Workforce for Future Challenges

Discover how healthcare is evolving, the workforce hurdles it faces, and the game-changing role of technology in overcoming these obstacles.


Ryan Flinn

Latest:

Novel Therapy Prevents Skin Cancer by Training Immune System’s Helper Cells

A small study of 18 patients with skin cancer found that the combination of vitamin D and chemotherapy provided an immune response that lasted up to five years.



Kathleen Ellmore

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.



Darren Ghanayem

Latest:

Strategies to Help Health Plans Prepare for Risk Adjustment, Star Ratings Changes

One of the changes that CMS has added is a Health Equity Index (HEI) reward to its Stars program. The agency will use HEI data collected this year and next to calculate 2027 Star Ratings, so plans must capture member data on every measure included in the HEI.


Curtis Sherbo

Latest:

Patient Engagement: A Key Element for Success in Value-Based Care

To support a value-based care model, healthcare organizations should focus on creating meaningful engagement throughout the patient's journey. This includes contacting patients at the right time through the right channel with relevant messages.


Rich Parker, M.D.

Latest:

The Impact of Vaccines on Long Covid

Research suggests that COVID-19 vaccination may serve a therapeutic effect, possibly reducing the risk of developing long COVID when administered to those currently infected.


Sabrina Serani

Latest:

CAR T-cell Therapy Shows 6-Year Durability in CLL Patients

A study suggests that a novel CAR T-cell therapy could be a curative treatment for some patients with chronic lymphocytic leukemia, with 25% of responders still in remission after 6 years.

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