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CMS Rule on Diabetes Prevention a Missed Opportunity That Puts Seniors at RiskThe proposal to mostly leave virtual providers out of the 2018 launch of the Medicare Diabetes Prevention Program makes no sense in light of the evidence that these programs work.
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Contributor: To Address Uncontrolled Asthma, Understand the Right Treatments for the Right PatientsNot all asthma is created equal, nor will all therapies work for all patients. With continued innovations in asthma treatments offering new, improved options for patients, we are more prepared than ever to address uncontrolled asthma head-on.
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Contributor: Preparing for Massive MTM Program Expansion—Pharmacy-Led Medical Cost Savings to Fund CMS ChangesChanges in the medication therapy management (MTM) program willl require planning on how to best fund this program in a way that drives medical cost savings.
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Prescription Drug Pricing: Give the People What They WantIt's time to give the people what they want-real action to make pharmaceutical pricing more transparent, rational, and sustainable.
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How Michigan Hospitals Utilize Technology to Track and Target Heart Failure CareHospital participants shared how they have utilized technology to enhance care for heart failure patients. Below are some highlights of these resources and initiatives.
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Strengthening Intergenerational Patient–Provider RelationshipsAs more millennials enter the healthcare workforce, health outcomes of the baby boomer generation increasingly will depend on the quality of communication with a generation that has grown up in a very different time.
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Four Tips to Help Healthcare Companies Reduce Their Risk of Cyber AttacksThe recent global breach hit the United Kingdom's National Health Service especially hard. But outdated systems and a lack of updates made the incident predictable. Some simple steps could have reduced the risk.
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Value-Based Care in Uncertain Times: Navigating the Quality Payment ProgramThough there are many unknowns regarding how the Trump administration will affect policy, there is bipartisan support for lowering costs and increasing quality. The Medicare Access & CHIP Reauthorization Act of 2015 is a separate law that was passed with 92% bi-partisan support in 2015. Read on for tips on creating a strategy that will set you up for success under advanced alternate payment models.
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Scaling the Cell and Gene Therapy Supply Chain for GrowthWhile the cell and gene therapies approved so far are indicated for rare diseases with small patient populations, the successes of chimeric antigen receptor-T (CAR-T) therapies and expanding interest from biopharma stress the need to rapidly scale the supply chain as these therapies move toward commercial availability for more disease states and larger patient populations.
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Can We Stop Surprise Medical Bills AND Strengthen Provider Networks? California DidSince California passed legislation in 2016 to protect patients from surprise medical bills, there have been questions about whether the law would reduce the number of in-network specialty physicians. A new, comprehensive study shows that in-network specialty doctors in the state have actually increased–not decreased–since 2017.
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Two New Advanced APMs Could Be the Answer for Medical SpecialistsThe proposed payment models could fill a void for gastroenterologists, a key field for Medicare given the high number of enrollees treated for colorectal cancer.
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Community Providers May Struggle With CMS Rule on the Diabetes Prevention ProgramThe proposal from CMS may make it difficult for groups that have been providing the DPP to take part in Medicare reimbursement.
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Radiopharmaceuticals Are Showing Promise as the Next Generation of Cancer TreatmentRecent major investments signal growth in an emerging therapeutic sector.
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Addressing Social Determinants of Health to Drive Member Retention, OutcomesWith considerable evidence that interventions aimed at social determinants of health can positively influence health outcomes and costs, the discourse is changing among providers and policy influencers to look beyond disease and clinical conditions.
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Workplace Wellness Can Be Hazardous to Your HealthThe health hazards of workplace wellness programs fall within 6 categories.
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Contributor: MA Plans Can Leverage Advanced Technology to Shore Up Risk Adjustment PracticesFaced with new government regulations, Medicare Advantage (MA) organizations should be utilizing technology to increase the accuracy of their coding, mitigate their risk, and ensure appropriate care for members.
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Towards Healthcare Interoperability: What Must Be Done?Interoperability is becoming the most sought-after in healthcare, but needs further standardization.
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The MACRA Landscape: Risk and Reward? Part IIRead on for a breakdown of what to expect from the near-final MACRA rule announced by CMS on October 14, 2016.
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Where's the Evidence? Barriers to Analyzing Digital Health's ImpactWhile digital health companies strive to address important healthcare issues by developing products and service offerings in various categories such as genome sequencing, analytics, telemedicine, mobile apps, and population health management tools, little evidence is available in the digital space when it comes to peer-reviewed publications, measurement of potential impact, and effect on patients with the greatest burden of disease, says Meridith Peratikos, Director of Enterprise Research, axialHealthcare.
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Federal Health IT Plan Recognizes Shortfalls of the Past“The course of history shows that as government grows, liberty decreases.” --Thomas Jefferson
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Trust—Doctor, You Have ItThe fact that trust cannot be purchased highlights an important truth: trust needs to be earned. And healthcare professionals have earned it.
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Drivers of Patient Experience in Medicaid Managed CareThough they may not directly provide patient care for their members, managed care organizations (MCOs) play a substantial role in the patient experience of millions of Medicaid enrollees.
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CAQH Index: Cost of Doing Business Falls as Complexity, Volume RiseThe CAQH Index, an annual study of progress to simplify healthcare administrative functions, found signs that the US healthcare system has become more efficient and the cost of doing business may be declining.
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Make Accreditation Part of Your IT Risk Management StrategyAs healthcare continues to see high-profile data breaches, underwriters are looking for third-party accreditation before issuing cyber-security policies.
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Managed Care in 2020 and Beyond: The Decade for Integrated, Individualized CareCardinal Innovations Healthcare is the largest specialty health plan in the country, insuring more than 850,000 North Carolinians with complex needs. Using a community-based model of care management, Cardinal Innovations has led the way in developing services, processes and solutions that improve the lives of our members and their families. Recognized for operational excellence, innovative solutions and superior outcomes for members, accuracy and speed of payments to providers, and cost-effective funds management, Cardinal Innovations is a leading healthcare company in the United States.
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Four Ways to Protect Yourself From Ransomware AttacksRemoving outdated systems and using offsite backup strategies are keys to protecting a health system from ransomware attacks, which are on the rise.
