Managed Care Experts

Social Determinants of Health Generate Drastic Cost Reductions

2018-05-30T00:25:42-04:00By |Managed Care, Population Health, Trends, Uncategorized, Utilization Management|

New research released by WellCare Health Plans, Inc. and the University of South Florida (USF) College of Public Health, Tampa, and published in Population Health Management, reports that healthcare spending is substantially reduced when people are successfully connected to social services that address social barriers, or social determinants of health, such as secure housing, medical transportation, healthy food programs, and utility and financial assistance.

CMS Prioritizes Patient-Centered Care over Paperwork

2018-05-01T15:33:04-04:00By |Health Care Reform, Managed Care, Uncategorized|

A new survey exams the attitudes, perspectives, and plans of healthcare leadership that are shaping telemedicine’s application, value, and potential. The research explored telehealth services adoption rates and drivers, budgets and ROI, the technology’s role in delivering care, and the factors important to executives when selecting a solution for their organization.

Flaws Found in Recent 340B Study? AHA Responds To NEJM

2018-02-06T20:07:26-04:00By |Big Data, Managed Care, Trends|

The shift under way in payment in US health care - from volume to value - has sparked interest in new contracting arrangements to pay for prescription drugs. The objective of these new arrangements is to reward successful outcomes of medication use in patients, rather than pay based on the volume of drugs sold. Unfortunately, value-based contract barriers stand in the way of one approach to managing drug costs and obtaining better value for money spent. However, achieving the full potential of these contracts will necessitate regulatory and other changes.

Medicaid Expansion Linked To Better Clinical Care

2018-01-25T22:58:40-04:00By |Managed Care, Medicare and Medicaid|

ACA Medicaid expansion, was associated with an increased probability of patients presenting with less complicated surgical disease and a greater likelihood of patients receiving optimal surgical management after admission and linked to better access to surgery and higher quality surgical care, according to a new study from Harvard T.H. Chan School of Public Health.

Social Determinants Vital To Payer Improvement

2017-12-19T18:50:38-04:00By |Managed Care, Population Health, Trends, Uncategorized, Utilization Management|

A report from Blue Cross Blue Shield Association, was released linking social determinants of health to differences in health across communities. From this report payers can see how demographic, behavioral, and structural factors impact health conditions of their members in different ways and gain greater insight into these differences to better understand population’s overall health.

UnitedHealthcare Shares Consumer Sentiment Results

2017-10-10T19:45:20-04:00By |IRO, Managed Care, Services|

More Americans are turning to technology first to evaluate health conditions, and a growing number are interested in using the internet to access medical care, while opportunities remain to improve peoples’ understanding of basic health insurance terms and the connection between lifestyle choices and disease, according to a new study. UnitedHealthcare shares results in a new report.

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