5 Metrics that Will Define Healthcare

Vanderbilt’s Stacie Dusetzina and colleagues explain how the ‘copay adjustment’ programs work in this week’s JAMA Internal Medicine and also shed light on third strategy used by insurers and pharmaceutical benefit managers, the alternative payment program.

In this month’s episode of the "What's On Your Mind podcast," Peter Wehrwein, managing editor of MHE connects with the now Chief Clinical Officer of OptumRx Integrated Pharmacies, David Calabrese. In this conversation, David touches on his transition in January as OptumRx’s former chief pharmacy officer and market president of health plans and PBMs to his new role as Chief Clinical Officer where he now focuses more on things such as specialty pharmacy to home delivery — with an overall goal of creating whole-patient care. Throughout the conversation, Calabrese also touched on the market’s hot topic of insulin prices and behavioral health services within the OptumRx community, among other topics.

Since 2017, two lawsuits and two state audits have cast a harsh light on Medicaid managed care, which served 845,000 adults and children at a cost of almost $6 billion last year.

In this week’s episode of Tuning In to the C-Suite podcast, Briana Contreras, an editor of Managed Healthcare Executive spoke with Julien Pham, MD, founder and managing partner of Third Culture Capital (3CC).

There are many reasons the ransomware problem has been hard to stop. One reason is that ransomware is good business. A 2021 U.S. Treasury Department identified more than $5 billion worth of outgoing bitcoin cryptocurrency payments it suspects may have been related to ransomware attacks.

Anesthesiologists and emergency department physicians have formed organizations to push back against the firms.