Aug 24, 2018 | Managed Care Friday
1. 64: That’s the percentage of Americans who reported they would attend an appointment via video telehealth, according to an American Well Telehealth study. The Council of Accountable Physician Practices and the Electronic Data Interchange released new documents designed to help healthcare providers in developing and launching telelhealth and telemedicine services. These documents, called “A Roadmap to Telehealth Adoption: From Vision to Business Model,” contain information designed to help identify resources of federal and state regulations as well as policies, pilot programs and use...
Aug 17, 2018 | Managed Care Friday
1. 12.8: That’s the percentage of adolescents In the US who experience at least one episode of major depression according to the National Institute of Mental Health. New research shows depression in teens is linked to parents, and when treating it, their parent’s mental health improves as well. As social creatures, treating one member of the family helps the other. Check out this story and study we did related to the impact of sports on parents and their kids. Click here 2. Palliative Outsourcing Avalanche: Several Anthem MCOs now use a vendor called Aspire to provide Palliative support to...
Aug 16, 2018 | Medicaid, Medicaid Managed Care
In early August, the state of North Carolina released a request for proposal for plans seeking to participate in its newly-launched Medicaid managed care. The state will shift from a predominately fee-for-service model to a managed care model, starting in late 2019. North Carolina is the largest state left with an unmanaged Medicaid population, with about 2 million covered lives. Click to read more.
Aug 15, 2018 | Drugs, Medicare Advantage, Physicians
CMS recently issued new guidance that allows Medicare Advantage (MA) plans to use step therapy for Part B drugs, starting in plan year 2019. According to the CMS memo, MA plans would be allowed to have patients start treatment with a preferred drug and then shift to other therapies only if medically necessary. We believe interested parties will challenge the legality of the program, and will also turn to Congress to try and weaken or block the action. If step therapy is allowed, though, we believe it could materially impact a subset of Part B drug categories. Click to read more.
