Hospitals & Providers

Risk adjustment has great potential if you follow these three simple rules.

As hospitals begin to search for key post-acute providers and implement new care pathways, providers should be aware of program waivers that afford greater flexibility in determining the most cost-effective care possible to ensure good outcomes for patients within the CJR model.

How one health system and one health plan are fighting the obesity epidemic

AHIP’s president and CEO Marilyn Tavenner discusses the association’s top priorities, challenges, and opportunities.

Experts break down the controversy over the agency’s release of Overall Hospital Quality Star Ratings.

Are you tracking your prospective pharmacy partners to measure their potential impact on your Star Rating? You should be.

Surveys conducted by the AACE with support from Sanofi US, identified differences in perceptions among adults living with type 2 diabetes. What healthcare professionals don't know may surprise you.

The standard of care for patients unable to drain their bladder is catheter use, but new alternatives reduce risk of antibiotic-resistant superbugs and costs to the healthcare system.

Obesity affects almost 38% of U.S. adults, according to the CDC’s National Health and Nutrition Examination Survey. Here’s how plans and providers can create positive change.

The Medicare Star Ratings program is one way regulators are trying to improve outcomes while reducing costs, but what is really at stake for health plans, and do consumers even care?

Given what will occur in California, what should executives be aware of? What does the future hold for exchanges nationwide? Experts weigh in.

The government recently filed lawsuits to block Aetna-Humana and Anthem-Cigna mergers. Here’s how experts say this will impact the industry.

Losing weight requires dramatic behavioral and lifestyle changes. Here’s how physicians can get patients on board.

The Managed Healthcare Executive editorial advisory board says healthcare executives should watch out for these seven leadership deficiencies.

President Obama recently reviewed the ACA. Find out what he said are the top successes, and how policy insiders are reacting.

The impacts of the ever-changing health care marketplace and how employers, brokers and carriers have adapted

HHS is taking formal steps to address opioid addiction, a widely recognized national public health crisis. Find out the policy changes.

Karen B. DeSalvo, National Coordinator for Health Information Technology, gives the best courses of action for top technology challenges and opportunities facing healthcare executives.

A new Quest Diagnostics and Inovalon study cites barriers to value-based care, but offers advice on how to overcome them.

All antibiotic use has the potential to contribute to the development of antibiotic resistance. That’s why it is key to reduce inappropriate antibiotic use in order to slow the growth of resistance.

Health plans must find new and meaningful ways to connect with patients of diverse backgrounds.

Is digital health integration the missing link in understanding chronic diseases and what should physicians be asking to ensure the data they want to receive is captured effectively?

Payers pair with providers to manage patients with chronic disease at a distance.

Multiple factors are moving mental healthcare to a front burner issue in managed care.

In an era when adherence to specialty pharmaceuticals is disturbingly low, value-based pricing needs real-world results, not single-arm accelerated trials.