This article explores the impact of payment models (fee for service vs salary based) on practice patterns, including wait times and care for patients with chronic diseases.
The Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model provides the next great opportunity in moving a health care payment system toward paying for value and rewarding preventive care and keeping patients healthy.
Rates of preventive oral health services among pediatric medical visits in Florida were similar whether visits were paid via Medicaid comprehensive managed care or fee for service.
Relying on a 2-stage secret shopper survey, the authors found that inaccuracies in provider directories often persisted for well over 1 year.
This letter describes the experience of long-stay patients and provides a perspective of the need for more studies on outliers’ impact on health care.
This study presents a methodology for forecasting demand of COVID-19 on health resources in an integrated health system.
This report illustrates how providing vital diabetes medications to uninsured patients through a charitable medication distributor improves clinical outcomes.
Tara Vail is the Chief Operating Officer of HST Pathways and serves on the Board of the California Ambulatory Surgery Association.
The proposal to mostly leave virtual providers out of the 2018 launch of the Medicare Diabetes Prevention Program makes no sense in light of the evidence that these programs work.
Not all asthma is created equal, nor will all therapies work for all patients. With continued innovations in asthma treatments offering new, improved options for patients, we are more prepared than ever to address uncontrolled asthma head-on.
Changes in the medication therapy management (MTM) program willl require planning on how to best fund this program in a way that drives medical cost savings.
It's time to give the people what they want-real action to make pharmaceutical pricing more transparent, rational, and sustainable.
Hospital participants shared how they have utilized technology to enhance care for heart failure patients. Below are some highlights of these resources and initiatives.
As more millennials enter the healthcare workforce, health outcomes of the baby boomer generation increasingly will depend on the quality of communication with a generation that has grown up in a very different time.
The recent global breach hit the United Kingdom's National Health Service especially hard. But outdated systems and a lack of updates made the incident predictable. Some simple steps could have reduced the risk.
Though there are many unknowns regarding how the Trump administration will affect policy, there is bipartisan support for lowering costs and increasing quality. The Medicare Access & CHIP Reauthorization Act of 2015 is a separate law that was passed with 92% bi-partisan support in 2015. Read on for tips on creating a strategy that will set you up for success under advanced alternate payment models.
While the cell and gene therapies approved so far are indicated for rare diseases with small patient populations, the successes of chimeric antigen receptor-T (CAR-T) therapies and expanding interest from biopharma stress the need to rapidly scale the supply chain as these therapies move toward commercial availability for more disease states and larger patient populations.
Since California passed legislation in 2016 to protect patients from surprise medical bills, there have been questions about whether the law would reduce the number of in-network specialty physicians. A new, comprehensive study shows that in-network specialty doctors in the state have actually increased–not decreased–since 2017.
The proposed payment models could fill a void for gastroenterologists, a key field for Medicare given the high number of enrollees treated for colorectal cancer.
The proposal from CMS may make it difficult for groups that have been providing the DPP to take part in Medicare reimbursement.
Recent major investments signal growth in an emerging therapeutic sector.
With considerable evidence that interventions aimed at social determinants of health can positively influence health outcomes and costs, the discourse is changing among providers and policy influencers to look beyond disease and clinical conditions.
The health hazards of workplace wellness programs fall within 6 categories.
Faced with new government regulations, Medicare Advantage (MA) organizations should be utilizing technology to increase the accuracy of their coding, mitigate their risk, and ensure appropriate care for members.
Interoperability is becoming the most sought-after in healthcare, but needs further standardization.