Practice Management

Five Health Execs’ New Year’s Resolutions

December 14, 2018

We asked the Managed Healthcare Executive editorial advisory board: “What is your New Year’s resolution and how do you plan to achieve it?” Here’s what they said.

AHIP pilot program aims to improve doc directories

April 21, 2016

An accurate account of your provider roster is essential to driving value-based care, according to one expert.

Four ways to a better patient healthcare experience

January 05, 2016

Coordination is key in improving adherence and outcomes in patients with chronic conditions. Here’s how.

Social media: ROI for health plans?

January 22, 2015

According to the research firm Gartner, Inc., information technology is subject to a five-phase acceptance cycle: a Technology Trigger, Peak of Inflated Expectations, Trough of Disillusionment, Slope of Enlightenment, and Plateau of Productivity. Even zealous advocates of social media marketing (SMM) admit their craft is currently stuck in the disillusionment phase.

Value-based formularies take hold

January 21, 2015

Unlike a traditional formulary, the value-based formulary emphasizes the clinical effectiveness of a drug rather than cost so that if a drug is very effective but expensive, it might still fall on tier one.

M & A deals reach record high under reform

January 21, 2015

From Blue Shield of California's recently-announced purchase of a Medicaid plan to Partners HealthCare's hard-fought effort to fold more hospitals into its Massachusetts health system, the volume of mergers and acquisitions in the healthcare sector has steadily climbed and now exceeds M & A activities in all other U.S. industries. The surge is being fueled by payers and providers seeking new business opportunities in the post-ACA healthcare market, and 2015 is on track to be another record-breaking year.

Ebola's lessons

January 21, 2015

Envisioning a public health threat, managed care recently notched up its readiness for an Ebola outbreak in the United States. Valuable lessons emerged from the latest effort, adding to the knowledge gleaned from other epidemics, such as the HIV/AIDS and SARS viruses and the bird flu.

Strategies for lowering C-section rates

January 21, 2015

Nearly a year after two medical societies released a national consensus statement on the safe prevention of certain C-sections, broad consensus seems to boil down to this: Steps must be taken to lower C-section rates in the U.S., and strong outreach to ob/gyns is critical for success.

Shared decisions save costs

March 01, 2013

More than $23 per member per month saved when coaches offer remote assistance

Compliance focus, education aid in diabetes management

November 01, 2006

Recent studies on diabetes control are wrangling for attention with some confirming the National Health and Nutrition Examination Survey (NHANES), which suggests that diabetes control declined through the late 1990s, while others indicate that diabetics are maintaining better control.

Part D puts PBMs in the political spotlight

November 01, 2006

The emergence of pharmacy benefit management companies (PBMs) as major players in drug benefit design and pricing has generated criticism as well as praise. PBMs previously served as drug benefit administrators for employers and other payers. But as sponsors of Medicare Prescription Drug Plans (PDPs), they now assume risk and design coverage and payment options.

Medicare PDP enrollment

November 01, 2006

Recent data supports the success of Prescription Drug Plans (PDPs) under Part D.

Medication management not well defined in MMA

November 01, 2006

Medication therapy management (MTM) has long been a part of the pharmacy lexicon and is based on the premise that the right medication in the right dose gets to the right patient. This is to ensure that optimal outcomes are achieved with the highest safety. Numerous examples of pharmacy programs in diverse settings utilize the skills of the pharmacist to optimize drug therapy and improve outcomes and assure safety. The Veterans Administration, academia, health plans, as well as community pharmacies have all been settings where medication management of the patient has occurred.

For whom the NPI tolls: Deadline for HIPAA compliance closes in

November 01, 2006

The deadline draws near for the healthcare industry to comply with one of the final regulations mandated by the Health Insurance Portability and Accountability Act (HIPAA) in the ongoing industrywide effort to get all arms on the same electronic page.

Plans expand 2007 drug benefit options

November 01, 2006

Washington, D.C.-The anticipated shakeout in Part D plans is not occurring this year. In fact, insurers and pharmacy benefit managers (PBMs) are offering more drug coverage options at lower costs for seniors.

Recovering from disaster: The industry reflects on the impact of Hurricanes Katrina and Rita on healthcare delivery and e-health records

October 01, 2006

National Reports-New Orleans officials recently announced that they believe the city has reached half of its previous population prior to Hurricane Katrina. Some of the city's hospitals have not reopened, and many doctors and allied health professionals have not returned to the city.

Recovering from disaster: The industry reflects on the impact of Hurricanes Katrina and Rita on healthcare delivery and e-health records

October 01, 2006

National Reports-New Orleans officials recently announced that they believe the city has reached half of its previous population prior to Hurricane Katrina. Some of the city's hospitals have not reopened, and many doctors and allied health professionals have not returned to the city.

Providers and payers work to ease into e-prescribing

October 01, 2006

Doctors' handwriting has always been a source of jokes, but it's not so funny when poorly written prescriptions lead to medication errors. Electronic prescriptions have the potential to save lives by negating errors in deciphering prescriptions and alerting physicians to adverse drug interactions before they write a prescription.

HHS, Congress encourage e-health development

September 01, 2006

All health plans and providers that do business with Medicare, Medicaid and other federally sponsored health programs soon will have to adopt information technology standards and quality-measurement tools. The Medicare Modernization Act of 2003 (MMA) requires the Department of Health and Human Services (HHS) to establish standards for electronic prescription drug prescribing by 2008, and this policy is driving broader efforts to build health IT systems.