Managed Care Friday

Twenty: The number of emerging payer priorities ranked from 1 to 20 by commercial, Medicare Advantage and Medicaid managed care plan leaders are featured here in the 15th edition of our Healthcare Payer Index. A conference call to discuss the list will be held today, Friday, February 14th at 1 o’clock eastern. Dial 800-874-4559 (password is Cote41810). Nursing Rehab Center Turnaround: A northeastern nursing & rehab center is poised to turn a profit on their Medicaid business after years of losing millions, and has created a new behavioral health team of psych social workers, clinical...

CMS Releases Medicaid “Block Grant” Guidance

On January 30, CMS released guidance to states on an option to accept capped federal funding in exchange for broader flexibility in coverage of non-elderly adults that are not eligible based on disability. The most likely states to consider the option in the near tem are those that are interested in alternative approaches to Medicaid expansion. Click to read more.

Healthcare Tech Innovations: Top 10 List for 2020

New technology is emerging in every industry, but healthcare, in particular, is booming these days with new apps, robots, and telehealth initiatives designed to revolutionize both the diagnosis and treatment of leading health conditions. There are nearly 150,000 health-related apps alone, for example, though an IMS study found that very few are regularly used. As 2020 begins, more health plans, employers, physicians, and nurses on the frontlines of care are recommending apps as a way to change patient behavior. Here’s a look at our top 10 healthcare technology developments of the day. For...

BRG Healthcare Payer Index 2020

The top 20 health insurer priorities for managing care and costs in 2020 are now available in the 15th edition of the BRG Healthcare Payer Index, and this year’s rankings are full of surprises – eight new services previously unranked, a new #1 focus, and a host of changes in how payers are transforming how they pay for healthcare and what they value. Click to read more.

Managed Care Friday

42: The percent of physicians who just retired or changed jobs after an insurer acquired their business, according to our small poll of 103 who say their practice was bought by a health plan in the last few years. Age and quality of life and the ‘components’ of the deal were the leading factors. The 58% who stayed on were, for the most part, under 50. Lab Testing Utility: Physicians sometimes order lab tests as cover, sometimes because it’s protocol and sometimes because they have a hunch. The science behind their lab ordering behavior is increasingly interesting given a range of healthcare...