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Medicaid Expansion Population Profile: Study for Payers

February 20, 2018

The Senate released its version (a.k.a. Better Care Reconciliation Act BCRA) of the House’s AHCA. Payers and providers adjust as needed because healthcare reforms, like BCRA, AHCA, and ACA, continuously move through state and federal legislatures. Today’s blog, pulls together summaries from numerous resources allowing you a quick glimpse or a deep dive into what waits around the corner.

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

Survey Results Define CMO Responsibilities

Innovations in Medicaid Managed Care Organizations

February 20, 2018

The first nationwide benchmark study measuring the health care industry’s progress in combating the opioid crisis was released. This important baseline analysis shows the positive steps clinicians and insurance plans have taken together – and identifies specific actions that can be taken to reduce addiction and abuse.

Benchmark Study On The Opioid Crisis

February 13, 2018

Implementation Of Telehealth Services Update: Survey

February 13, 2018

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

February 6, 2018

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.

Medical Texting: Rx Refill Rates Increase and Privacy Warnings

February 6, 2018

For payers, identifying doctors who write more opioid prescriptions can be key for any successful opioid management program. Using the one factor influencing opioid prescription habits, payers can target education improving the overall provider network performance. Physicians trained at the United States’ lowest-ranked medical schools write more opioid prescriptions than physicians trained at the highest-ranked schools, according to a study by Princeton University.

Medicare Advantage Provider Directory Failures Up To 52%

January 30, 2018

In its second round of online provider directory reviews, the Centers for Medicare & Medicaid Services found that 52% of the Medicare Advantage provider directory locations listed had at least one inaccuracy.

Kentucky Medicaid Lawsuit Guide: 5 Things To Know

January 30, 2018

On January 24, 2018, 15 Kentucky Medicaid enrollees filed a lawsuit in the U.S. District Court for the District of Columbia challenging CMS’s authority to issue the work requirement policy and approve the Kentucky waiver. This issue brief answers 5 key questions about the Kentucky Medicaid Lawsuit.

Medicaid Expansion Linked To Better Clinical Care

January 25, 2018

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.

New Report: Telemedicine Consults Save $500 Per Patient

January 23, 2018

The cost savings demonstrated in this study will support state Medicaid agencies, payers, and other health systems seeking new ways to improve access and quality while reducing telemedicine consults cost.

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