Feb 14, 2020 | 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...
Feb 12, 2020 | Devices, Products
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...
Feb 10, 2020 | BRG Publications, Payers
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.
Feb 7, 2020 | 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...
Feb 6, 2020 | 340B, Medicare Advantage, MedPAC, Part D
In its January 2020 meeting, the Medicare Payment Advisory Commission (MedPAC) responded to a congressional request on the 340B drug program’s potential incentive for hospitals to use more expensive drugs and presented status reports of ongoing research into Part D, the assignment of beneficiaries to ACOs, and initial modeling of a redesigned MA quality bonus program. Click to read more.
Feb 5, 2020 | Medicare, MedPAC
Recent developments in Ear, Nose, and Throat (ENT)/Otolaryngology reimbursement and legislation. Click to read more.
Jan 31, 2020 | Managed Care Friday
20 Million: The amount Blue Shield of California has pledged for behavioral health services, largely to support California’s large homeless population. The money will go to the California Access to Housing and Services Fund, a new initiative proposed by the governor in the most recent budget. Blue Shield of CA also recently launched a 10 year, $10M plan, Blue Sky, focused on supporting mental health for students. Gateway to Value: If you ever doubted insurer investment in value care models, look to Blue KC, which has partnered with Cedar Gate Technologies to use analytics to help the insurer...
Jan 30, 2020 | Drugs, Pharmacy, Products
The U.S. Supreme Court will hear a case regarding whether or how states can regulate Pharmacy Benefit Managers. Click to read more.
Jan 29, 2020 | Physical Therapy, Physician Fee Schedule
Recent developments in Physical and Occupational Therapy reimbursement and legislation. Click to read more.
