Employer-based healthcare system under scrutiny

Amongst a few recommendations, Commonweath is encouraging how and how much we as payers, providers and consumers pay for primary care.

In this week's episode, Editor of Managed Healthcare Executive, Briana Contreras, had the pleasure of speaking with Chief Clinical Officer of WellSky, Tim Ashe, about the issue of Centers for Medicare and Medicaid Services cutting rates for Medicare home health. Tim addressed the solutions that are either underway or those that can potentially preserve access to these services.

Connecting the healthcare system and patients in a positive, empathetic, respectful way may help lessen the fatigue many groups have with the healthcare system at-large and individual healthcare providers, while improving health equity.

In this week's episode, MHE Editor Briana Contreras and Managing Editor Peter Wehrwein met with CIO of Prime Therapeutics, Jim Graham to discuss the process of an organization’s digital transformation from a traditional Pharmacy Benefit Manager to a complete data-driven drug management system. Graham addressed the risks an organization may come across to successfully transition to this system, but also mentioned the benefits to come.

Spending climbed by 2.7% in 2021. In 2020, it soared by 10.3%, fueled by federal government spending in response to the pandemic. The blizzard of calculations of 2021 healthcare spending by CMS’ actuaries also provides further evidence that utilization of healthcare services bounced back in 2021.

AMCP CEO Susan A. Cantrell spoke with Managed Healthcare Executive® about Preapproval Information Exchange (PIE) Act of 2022, which would allow drug manufacturers to share information about a drug with payers before the drug is approved. Cantrell says passage of the PIE Act would speed up patient access to new medications.