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Business Strategy
Fixing Prior Authorization: How to Improve Outcomes Using Episodic Care Paths
March 24, 2022
As the industry becomes oriented toward value-based care and its focus on high-value outcomes, utilization management must evolve to address the entire patient care journey, often across multiple episodes of care.
Some Consumers Over 65 Aren't Ready for Pickleball or Medicare
March 23, 2022
Tagged with the moniker "late retirees," this group of Medicare first-timers isn’t ready to call it quits. How can you help them? Find out below:
Meeting the Goal of Remote Patient Monitoring: Leveraging Data to Improve Clinical Workflows and Patient Outcomes
February 25, 2022
A recent study found 70% of patients believe remote patient monitoring enables better care management.
Replenishing a Depleted Workforce: How to Support Healthcare Workers Through COVID-19
February 24, 2022
With the COVID-19 pandemic ongoing and alarming levels of healthcare workers still experiencing stress, burnout, and other negative feelings surrounding their work, it's time to return the favors they've given countless others.
How to Tame Increasing Healthcare Costs and Deal With Staffing Shortfalls
February 16, 2022
Hiring assistants that work virtually and outsourcing medical coding are two ways that providers can navigate through these times of increasing cost pressures and staffing shortages.
Considering the Ideal Role for Non-Emergency Medical Transportation in Addressing SDoH in Medicaid and Medicare Populations
February 13, 2022
Medicare and Medicaid programs that serve the most-vulnerable Americans facing SDOH barriers can be major facilitators of appropriate non-emergency transportation to non-medical sites. But how do we determine what is appropriate, and what do we know about transportation services to non-medical sites today?
Luis Mosquera of Health Network One Addresses Alternative Payment Models Are the Key to Transitioning to Value-based Care
February 11, 2022
Briana Contreras, editor of Managed Healthcare Executive spoke with Luis Mosquera, CEO of Health Network One, a provider of specialty benefit management services for health insurers, in this week's episode. In this discussion, Luis and Briana talked about how value-driven decisions in a more value-based market can not only better manage costs for health plans, but create a plan of care to best meet patient’s needs. In order to do this, Luis strongly encouraged healthcare executives to experience alternative payment models and shared what payers should check off their list with a new model.
Dismantling Stigmas: How to Stop the Blame Game and Get Patients the Care they Need
February 10, 2022
There is a bias in this country against people whose medical condition is perceived to be “their fault”– in other words, the result of their own lifestyle choices. To combat stigma and its harmful effects, there needs to be broader understanding, even among medical professionals.
Collaboration, Access to Care, and Member Experience Essential to 2022 Health Plan Success
January 25, 2022
A look inside six trends that will shape and influence care, planning and performance over the next year for health plans.