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Articles

Their concerns come in response to the bill unveiled Sunday night by House Republicans that would tighten eligibility rules, create work requirements and freeze provider taxes under Medicaid—the federal-state program that insures nearly 80 million low-income Americans.

Healthcare Leaders Warn GOP Plan Would Deeply Chip Away At Medicaid Access

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Homelessness and HIV share common risk factors, according to Julie Dombrowski, M.D., M.P.H., professor of medicine at the University of Washington and director of HIV treatment initiatives at the King County, Seattle public health department.

The Relationship Between HIV and Homelessness  

Industry leaders and policy experts have said President Trump’s executive order on Most Favored Drug Pricing is flawed and ignores the basic economics of the global drug marketplace.

Trump’s Favored Nation Drug Pricing is Unworkable, Critics Say 

The House Energy and Commerce Committee has scheduled a public markup hearing for the Republican bill for tomorrow at 2 p.m.

House Republicans Propose Medicaid Changes, Including Work Requirements and Eligibility Checks

Managed Healthcare Executive gives C-suite executives in health plans and provider organizations news and strategies for value-driven solutions.

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1rem

Value-based care

Research published today in JAMA Health Forum Shows primary care physicians faced an average of 57 quality measures. The authors argue that many may interfere with care improvement and contribute to physician burnout.

PCPs and Quality: Too Much of a Measured Thing

For operational efficiency, value-based initiatives need a scalable digital infrastructure that can handle multiple reimbursement models, including fee for service.

Contract Management in a Value-Based Care Environment

How Capitation Contracts Benefit Providers, Payers and Patients

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

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

Participation in the main Medicare Shared Savings Program is decreasing but 132 accountable care organizations with 2.1 million assigned beneficiaries are participating in the ACO REACH model this year.

Outlook Bright for CMS ACO Programs, Says Signify’s Gronniger

Thus far, value-based contracts for prescription drugs has not been transformative because of the scalability challenge for payers, explained Gregory Warren, FSA, FCA, MAAA, partner and consulting actuary with Axene Health Partners.

Warren was the keynote speaker on day 2 of the 2022 PBMI Annual National Conference in Orlando, Florida.

Gregory Warren Discusses Measuring Value and Scaling Up Value-Based Contracting

Value-based care

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