Industry News
Seven Networking Tips for Health Execs
Managed Healthcare Executive
1/8/2019
Executive-level decisions can be complicated. Here are seven ways to turn to others to gain valuable insight.
Legal Considerations for Healthcare Organizations Exploring Value-Based Models
Managed Healthcare Executive
1/8/2019
Coming up with the benchmarks for measuring and rewarding quality and efficiency and finding the right provider partner are only part of the battle. Don’t forget about compliance with state and federal requirements.
Healthcare Midterm Election Results: A Marketing Toss-Up
Wunderman Health
12/10/2018
Lindsay R. Resnick of Wunderman Health outlines several key takeaways from the midterm election impacting healthcare marketing. In today’s contentious political landscape, healthcare brands have an opportunity to emerge as trusted community resources helping customers take ownership of their health by supporting value-based financial and clinical choices.
Google hires Geisinger CEO Dr. David Feinberg to lead healthcare business
Becker's
11/9/2018
Google announces today that they have selected Dr. David Feinberg, CEO of Geisinger Health System, to fill a newly created position of leading their healthcare division.
CMS will tweak, not overhaul, Medicaid managed care
Modern Healthcare
11/8/2018
After years of promising a major overhaul to an Obama-era managed care rule, the CMS has issued a proposed regulation that makes smaller changes to the standards states meet when running their Medicaid plans.
Report: 34 Percent of Healthcare Payments in 2017 Tied to APMs
Healthcare Informatics
10/30/2018
According to a report from the Health Care Payment Learning and Action Network (LAN),
one-third (34 percent) of total U.S. health care payments were tied to alternative payment models (APMs), such as shared savings/risk arrangements, bundled payments, or population-based reimbursements, in 2017, up from 23 percent in 2015.
Utah pays public employees to fill prescriptions in Mexico
The Salt Lake Tribune
10/30/2018
To fight high drug prices, Utah will pay for public employees to go fill prescriptions in Mexico. PEHP, which covers 160,000 public employees and family members, is offering plane tickets to San Diego, transportation to Tijuana, and a $500 cash payout to patients who need certain expensive drugs for multiple sclerosis, cancer and autoimmune disorders.
New Regulation Requiring Drug Pricing Transparency
CMS
10/23/2018
On October 15, 2018, the Centers for Medicare and Medicaid Services (CMS) unveiled its proposed rule requiring direct-to-consumer television advertisements for prescription drug and biological products to contain the list price (defined as the Wholesale Acquisition Cost) if the product is reimbursable by Medicare or Medicaid.
Payers Save Money by Doling Out Patient Incentives
Managed Healthcare Executive
8/31/2018
Some health insurers are giving members cash rewards when they choose less-expensive healthcare providers or have procedures or tests performed at lower-priced facilities.
CMS Processes State Medicaid Requests, Approvals 23% Faster
HealthPayer Intelligence
8/17/2018
CMS has announced that an agency initiative to streamline state Medicaid approvals and state plan amendments (SPAs) has increased approval processing speed by 23 percent.
Parkland Center for Clinical Innovation (PCCI) named one of 2019 10 Best Tech Startups in Dallas
The Tech Tribune
8/17/2018
PCCI, who recently spoke at the Alliance Government Programs AND Risk, Compliance, Security and Privacy Value Visit, was named #7 on The Tech Tribute 2019 top 10 list of the very best tech startups in Dallas, Texas.
Shopping for Health Care Simply Does Not Work. So What Might?
New York Times
7/30/2018
High deductible plans aren't working as intended. A body of research shows that people do in fact cut back on care when they have to spend more for it. The problem is that they don't cut only wasteful care. They also forgo the necessary kind. Read to learn what might help.
Taking a Dive on Risk Adjustment
The Incidental Economist
7/16/2018
The Incidental Economist blogs about the recent announcement by CMS to halt risk adjustment payments until the litigation is resolved.
Trump administration freezes risk adjustment payments
Modern Healthcare
7/9/2018
The Trump administration is halting billions of dollars of payments to insurers under the Affordable Care Act's risk-adjustment program, a move that further disrupts the insurance market and could lead to more premium increases next year.
AMGA creates standardized quality reporting measurement set
Modern Healthcare
6/25/2018
AMGA endorsed a set of 14 quality measures for payers to use to simplify providers' reporting process for value-based purchasing programs.