MCOs Under Pressure to Do More with Less

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.

By integrating capabilities and services, we can create health experiences that are much more than the sum of their parts

If virtual care is achieve meaningful health outcomes in a primary care setting, it must be practiced within a bona fide hybrid approach.