How Can Medicaid Coverage Combat Opioids?

CMS has released new resources describing how states can leverage Medicaid services and health IT tools to support beneficiaries battling opioid addiction.

The organization released an Informational Bulletin to guide states on how to cover critical treatment services for Medicaid eligible infants with Neonatal Abstinence Syndrome (NAS), a postnatal drug withdrawal syndrome occurring primarily among babies exposed to opioids during gestation or shortly after birth.

Medicare Drug Prices Up Despite Decrease in Prescriptions

The Medicare Advantage program continues to grow in popularity with both consumers and health plans.

At least one-third of seniors are estimated to be in an MA plan rather than fee-for-service Medicare. As baby boomers retire in large numbers, health plans are competing to capture the Medicare Advantage market.

Telehealth Success Variables

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.

Healthy Options: Tech Companies Reduce Chronic Pain

Hinge Health, a San Francisco startup that developed a 12-week remote monitoring program to reduce chronic knee pain and back pain, has published the results of a randomized control study to illustrate the effectiveness of its program for chronic knee pain. The program is intended to provide a noninvasive alternative to surgery to reduce chronic musculoskeletal pain.

Social Determinants of Health Generate Drastic Cost Reductions

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.

CDC: America’s Uninsured Rate Rising During Trump’s First Year

The Trump Administration released “American Patients First,” the President’s blueprint to lower drug prices and reduce out-of-pocket costs. When it comes to the cost of prescription drugs, our healthcare system faces four major challenges: high list prices for drugs; seniors and government programs overpaying for drugs due to lack of the latest negotiation tools; out-of-pocket costs for consumers; and foreign governments free-riding off of American investment in innovation.

Members Want Provider Networks With Strong Online Presence

Medical review is the collection of information and clinical review of medical records by physician advisors (for providers reviewing cases before submissions) or a peer review team (for payers) to ensure that payment is made only for services that meet coverage, coding, and medical necessity requirements.

Here are 10 instances which can help you better identify when its time to look for a partner.

Trump Administration Plan To Lower Drug Prices and Reduce Costs

The Trump Administration released “American Patients First,” the President’s blueprint to lower drug prices and reduce out-of-pocket costs. When it comes to the cost of prescription drugs, our healthcare system faces four major challenges: high list prices for drugs; seniors and government programs overpaying for drugs due to lack of the latest negotiation tools; out-of-pocket costs for consumers; and foreign governments free-riding off of American investment in innovation.

Study: Hospital Prices Show ‘mind-boggling’ Variation

The prices hospitals negotiate with health insurance companies vary enormously within and across geographic regions in the United States, according to a new study coauthored by Zack Cooper (Yale), Stuart Craig (University of Pennsylvania), Martin Gaynor (Carnegie Mellon), and John Van Reenen (London School of Economics).

Physician Shortage Trend Cause for Concern

Analyzing your revenue cycle from start to finish can lead to recouping significant revenue dollars for your organization. Knowing what are the most impactful metrics sets revenue cycle experts apart.