
5 Strategies To Enhance Utilization Review and Case Management
Discover five innovative strategies to enhance utilization review and case management for better healthcare outcomes.
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Discover five innovative strategies to enhance utilization review and case management for better healthcare outcomes.
BHM Healthcare Solutions, Inc., (BHM), a leader in medical and behavioral health review services and healthcare analytics, announces the retirement of Jean Neiner, President and CEO, effective December 1, 2022. With this change, we are excited to announce that Eric Rosenberg will move into the position of President and CEO.
The uninsured rate among children increased between 2016 and 2017, representing 276,000 more uninsured children across the U.S. and the first observed increase in uninsured children since 2008, according to a recent report by the Georgetown University Center for Children and Families.
Insurers see outdated technology and a lack of automation as key challenges holding back their organization’s operational efficiency and driving up costs, according to new survey results from HealthEdge.
MedPAC proposed to slash payments in its March report to Congress. The commission specifically recommended a 30 percent payment rate reduction for off-campus standalone EDs that are no more than six miles from an on-campus hospital ED, according to the AHA.
America’s Health Rankings Annual Report, now in its 28th year, provides a holistic view of the health of the nation and of each state by analyzing 35 measures of behaviors, community and environment, policy, clinical care and outcomes data. The rise of premature death is a concern shared by health care professionals, payers, and leadership as well as their members.
With the CVS/Aetna acquisition, payers are grappling with new risk and a slack consensus on how to best prioritize and respond to them.
The Centers for Medicare & Medicaid Services (CMS) released the Star Ratings for the 2018 Medicare health and drug plans. With the release of the Star Ratings, people with Medicare will have improved access to high-quality health choices for their Medicare coverage in 2018. This news comes on the heels of the recent release of the benefit and premium information for Medicare health and drug plans which shows that there will be more health coverage choices and decreased premiums in 2018.
There was a significant change in uninsured numbers growing for people ages 35 to 49, adults making more than 400 percent of the federal poverty level ($47,520 for an individual and $97,200 for a family of four), and those living in states that have not expanded Medicaid, according to a new Commonwealth Fund survey. Policy fixes like expanding Medicaid in all states, making premium subsidies available to more people, and assisting consumers as they shop for coverage on the marketplaces, the report finds, could address some of the barriers the uninsured face in gaining coverage.
Sweeping repeal and replace legislation may be slowed, but does not mean significant healthcare changes are not coming off the legislative wish list. The debate on funding aspects of the healthcare law will likely continue through the 2018 election. The Health Insurance Tax (HIT) comes up for discussion and two organizations presented their takes on HIT’s impact on Medicare programs and payers.