All health plans and providers that do business with Medicare, Medicaid and other federally sponsored health programs soon will have to adopt information technology standards and quality-measurement tools. The Medicare Modernization Act of 2003 (MMA) requires the Department of Health and Human Services (HHS) to establish standards for electronic prescription drug prescribing by 2008, and this policy is driving broader efforts to build health IT systems.
Health plans should be using data, digital tools and human support to identify potential disruptions early, and whether a member is changing plans or managing a new health condition, the experience should feel guided rather than overwhelming.
Pretax adjusted income from operations from Express Scripts, Cigna's pharmacy benefit manager, fell by 21.5% compared with the third quarter of 2025, while income from operations of its specialty drug business jumped by 15%.
Annesha White, Pharm.D., M.S., Ph.D., and Fredrick Manasseh, Pharm.D., MBA, BCGP, explain where AI helps managed care pharmacy, where bias creeps in and what skills pharmacists need to oversee it.
Value-based care has scored some cost-saving successes, says Christopher Stanley, M.D., MBA, president of Henry Ford Health's Populance. Health systems that build their own value-based care strategy, rather than adopting particular models one by one, will be in the best position to succeed, he says.
The second half of our conversation with Christopher Stanley, M.D., MBA, the president of Henry Ford Health's Populance and the newest member of the Managed Healthcare Executive editorial advisory board.
The first part of our conversation with Christopher Stanley, M.D., MBA, the president of Henry Ford Health's Populance and the newest member of the Managed Healthcare Executive editorial advisory board.
Unifying care management doubled patient outreach with the same staff, and virtual physical therapy is cutting costs, says Populance's Christopher Stanley, M.D.