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.
|Articles|August 1, 2004
Industry protected under ERISA as Texas state law is pre-empted
On June 21, a unanimous U.S. Supreme Court held that state law is completely pre-empted by the Employee Retirement Income Security Act (ERISA)of 1974 with respect to disputes over denial of benefits under ERISA-regulated health benefit plans. The Court's ruling appears to insulate managed care organizations from punitive and extra-contractual damages related to denial of benefits. In its decision, the Court overruled two lower court rulings.
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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.
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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.
Christopher Stanley, M.D., MBA, on the early population health wins of Henry Ford Health's Populance
Unifying care management doubled patient outreach with the same staff, and virtual physical therapy is cutting costs, says Populance's Christopher Stanley, M.D.
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