News

As ACOs continue to grow in the healthcare sector, it is imperative that a liaison is in place to act as an intermediary between ACO members and patients to help achieve desired outcomes.

This May, CMS published a final rule addressing Medicaid managed care, through which the regulatory requirements for both the Medicaid MCOs and for states managing the plans has become even more complex.

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.

A senator is investigating whether Medicare's prescription drug benefit is vulnerable to manipulation by pharmaceutical companies after an exclusive Associated Press report showed that Medicare’s spending on certain drugs soared by 85 percent.

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

Obesity and associated comorbidities strain the healthcare system, so why has R&D for new weight loss medications been lackluster?

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.

As the 2016 presidential election approaches, analysts and experts are advising healthcare executives to watch and monitor certain issues.

Health insurers and providers are looking for ways to grow outside of the United States. Here’s a look at some of the tactics that are picking up traction.

FDA added new safety labeling changes for a class of antibiotics, fluoroquinolones (Levaquin, Cipro and other branded drugs), to enhance warnings about their association with disabling and potentially permanent side effects. Plus, the new labeling says that the drugs’ use should be limited in patients with less serious bacterial infections.

FDA approved lixisenatide (Adlyxin, Sanofi-Aventis), a once-daily mealtime GLP-1 receptor agonist injection for type 2 diabetes, which will compete against the once-weekly pen dulaglutide (Trulicity, Eli Lilly) and the injectable liraglutide (Victoza, Novo Nordisk).

Mayo Clinic researchers found that beyond overtesting, focus on HbA1C levels can lead to serious harms for patients, especially as more diabetes drugs are needed to keep HbA1C within desired targets.

A large-scale observational study led by Columbia University researchers may offer new approach to studying diverse patient groups.

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.

GAO report raises questions about programs for Medicare/Medicaid beneficiaries, but industry insiders remain optimistic.

To participate in Medicare and Medicaid, hospital and critical access hospitals (CAHs) would need to meet new criteria.

Michael Abrams of Numerof and Associates healthcare consulting firm discusses how the DOJ’s actions to block the Anthem-Cigna and Aetna-Humana mergers could affect the industry.

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

Several lawsuits have been filed by qualified health plans offering coverage on the Affordable Care Act health insurance exchanges.

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

FDA recently approved the New Drug Application (NDA) for (lorcaserin HCl) CIV extended-release 20 mg tablets (Belviq XR, Eisai Inc. and Arena Pharmaceuticals), a once-a day dosing option for chronic weight management.

FDA recently approved an expansion to the prescribing information for darunavir (Prezista, Janssen Therapeutics), to treat pregnant women with HIV.