To fully leverage SDOH information and provide more complete services throughout the care continuum in support of value-based care, payers should include community-based organizations (CBOs) in their value-based care network contracting strategies. Doing so creates a broadened, higher performing set of resources to keep people healthy and at home.
The VA recommends against offering this agent to patients with Alzheimer’s dementia, mild or otherwise.
At this time, two of three conferences have been reverted to a in-person and virtual format. This includes The American Urological Association (AUA) 2021 Annual Meeting and the Society for Immunotherapy of Cancer (SITC) 36th Annual Meeting.
Everything from the amount of daylight in a room to the timing of vital sign checks during the night can influence the sleep of patients in intensive care units and thus their recovery.
In this week's episode, editors of Managed Healthcare Executive, Peter Wehrwein and Briana Contreras caught up with MHE Editorial Advisory Board member David Calabrese, market president of Health Plans/PBMs at OptumRx, for another segment of the Meet the Board series. The three discussed Calabrese’s career history, his personal wellbeing lifestyle, and his thoughts on the approval of the Alzheimer’s drug Aduhelm, as well as the Biden Administration's interest in putting more generics and biosimilars in the market.
The program and proposed integrations could produce $15 million in savings annually.
A new meta-analysis summarizes the dangers posed sleep apnea, which include a doubling of the risk of sudden death from cardiac causes. It is still unclear whether continuous positive airway pressure (CPAP), one of the main treatments for obstructive sleep apnea, lowers that risk.
The decision follows an advisory committee recommendation not to approve because of safety issues.
Artificial intelligence can help deal with everyday problems such as prior authorization and high utilization. But payers are also eyeing it for loftier purposes.
Libtayo also reduced the risk of death by 29% compared with chemotherapy alone.
Bridging the precision medicine gap.
NCCN adds Rylaze to guidelines soon after was approved by the FDA and a British company reports positive results for its CAR-T therapy.
The FDA’s controversial approval of Aduhelm (aducanumab) has put a spotlight on the accelerated approval pathway that the agency used to approve the drug.
The American Academy of Ophthalmology says biosimilar alternatives to Avastin have never been tested in the eye.
One-quarter of Medicaid claims result in a denial of payment for at least one service included in the claim compared with just 7.3% of claims submitted to Medicare and 4.8% of claims submitted to commercial insurers
Previously patients administered as two, 75-mg shots. Now they can inject a single 150-mg dose.
It's rate-setting season for insurers, although the full picture for 2022 premiums won’t emerge for some months yet.
In this final part of a two-part video series, Briana Contreras, associate editor of Managed Healthcare Executive, spoke with Summit Health’s Chief Quality Officer Ashish D. Parikh, MD, and Chief of Population Health Jamie Reedy, MD, about value-based care programs and contracts within Summit Health and what it takes to invest and implement these programs into your healthcare organization.
AstraZeneca gets FDA nod for Saphnelo, BMS pulls indication for Istodax, Merck to seek another use for Keytruda, Tecentriq is granted priority review for NSCLC and COVID-19 cocktail gets expanded EUA.
In this first part of a two-part video series, Briana Contreras, associate editor of Managed Healthcare Executive, spoke with Summit Health’s Chief Quality Officer Ashish D. Parikh, MD, and Chief of Population Health Jamie Reedy, MD, about value-based care programs and contracts within Summit Health and what it takes to invest and implement these programs into your healthcare organization.
The therapy for HIV-related pneumonia was exposed to cold weather during shipment.
FDA approval means that pharmacists can swap biosimilar Semglee, an insulin product, for brand-name Lantus, although state-level pharmacy rules may apply.
The therapy can now be used for post-exposure prevention in people at high risk for progression to severe disease.
Managed Healthcare Executive had a conversation with Kelly Chillingworth, RPh, director of business development at RxBenefits this week about the unique connection between pharmacy and telemedicine, what impact telemedicine & its pharmacy costs have on self-funded employers and how the right virtual care services a health provider offers to their members can be essential to building a competitive benefit.
By enabling a more efficient, integrated process, electronic payment solutions are optimizing payment processes for payers and providers at a time when reliable, accurate and timely payments are of utmost importance to healthcare organizations.
Recommendations include stronger CMS standards on SDoH data collection, greater transparency on supplemental benefit offerings within Medicare Plan Finder, and modifications to Star Ratings and risk adjustment to account for social risk factors
The Centers for Medicare and Medicaid Services and the Treasury Department recently proposed a new rule intending to expand access to health coverage for individuals currently in or interested in entering the Marketplace.
Artificial Intelligence in dentistry and dental benefits will lead to a shared understanding between consumers, dentists and insurers.
The FDA is expected to make a decision on this indication by December 1, 2021.
The Society for Immunotherapy of Cancer (SITC) released guidelines based on FDA approved immune checkpoint inhibitors (ICIs) for the treatment of urothelial cancer arising from the bladder and other areas of the urinary tract. The guidelines were based around therapies such as the programmed cell death protein 1 (PD-1) inhibitors Opdivo (nivolumab) and Keytruda (pembrolizumab) and the programmed cell death ligand 1 (PD-L1) inhibitors, Tecentriq (atezolizumab), Bavencio (avelumab) and Imfinzi (durvalumab).
