Medical management comes to the forefront

Pandemic-triggered changes in the healthcare industry have required hospitals, clinics, and other healthcare facilities to scale up their technology operations, resulting in high demand for tech experts.

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.

Larger payers have plenty of cash on hand to do deals but will look for “adjacencies” rather than merger and acquisition with other payers because of the regulatory environment, say Bain experts.

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.

What’s more valuable than the ability to identify problems within your business plan or strategy? The ability to find solutions to those problems before they arise.

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