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Authors


Yewande Kofoworola Ogundeji, PhD

Latest:

Impact of Payment Models on Medical Specialist Physician Practice Patterns

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.


Clif Gaus, ScD

Latest:

ACO REACH Brings Next Era of Medicare Payment Models

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.


Bradley D. Stein, MD, PhD

Latest:

Pediatric Oral Health Services in Medicaid Managed Care and Fee for Service

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.


Simon F. Haeder, PhD, MPA

Latest:

Persistence of Provider Directory Inaccuracies After the No Surprises Act

Relying on a 2-stage secret shopper survey, the authors found that inaccuracies in provider directories often persisted for well over 1 year.




José Antonio de la Hoz-Valle, MD, MSc

Latest:

The Impact of Outliers on Available Resources in a Teaching Hospital in Colombia

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.


Tori J. Finch, MS

Latest:

Continuously Updated Forecasting of SARS-CoV-2 in a Regional Health System

This study presents a methodology for forecasting demand of COVID-19 on health resources in an integrated health system.



Abby Sparkman, PharmD

Latest:

Charitable Medication Distribution Improves Care for Uninsured Patients With Diabetes

This report illustrates how providing vital diabetes medications to uninsured patients through a charitable medication distributor improves clinical outcomes.


Tara Vail, MBA

Latest:

Achieving Super-Outcomes Without Super-Costs: Reducing Orthopedic Surgery Costs and Improving Care in Managed Care Environment

Tara Vail is the Chief Operating Officer of HST Pathways and serves on the Board of the California Ambulatory Surgery Association.


Adam Fawer

Latest:

CMS Rule on Diabetes Prevention a Missed Opportunity That Puts Seniors at Risk

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.


Thomas C. Corbridge, MD, FCCP

Latest:

Contributor: To Address Uncontrolled Asthma, Understand the Right Treatments for the Right Patients

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.


Jason Z. Rose, MHSA

Latest:

Contributor: Preparing for Massive MTM Program Expansion—Pharmacy-Led Medical Cost Savings to Fund CMS Changes

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.


John Rother

Latest:

Prescription Drug Pricing: Give the People What They Want

It's time to give the people what they want-real action to make pharmaceutical pricing more transparent, rational, and sustainable.


Michigan Value Collaborative

Latest:

How Michigan Hospitals Utilize Technology to Track and Target Heart Failure Care

Hospital participants shared how they have utilized technology to enhance care for heart failure patients. Below are some highlights of these resources and initiatives.


Julie Potyraj

Latest:

Strengthening Intergenerational Patient–Provider Relationships

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.


Dan Konzen

Latest:

Four Tips to Help Healthcare Companies Reduce Their Risk of Cyber Attacks

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.


Richard Morris, MBA, PCMH CCE

Latest:

Value-Based Care in Uncertain Times: Navigating the Quality Payment Program

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.


Kate Means

Latest:

Scaling the Cell and Gene Therapy Supply Chain for Growth

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.


America`s Health Insurance Plans

Latest:

Can We Stop Surprise Medical Bills AND Strengthen Provider Networks? California Did

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.


Fred Rosenberg, MD

Latest:

Two New Advanced APMs Could Be the Answer for Medical Specialists

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.



Brenda Schmidt

Latest:

Community Providers May Struggle With CMS Rule on the Diabetes Prevention Program

The proposal from CMS may make it difficult for groups that have been providing the DPP to take part in Medicare reimbursement.


JT Ripton

Latest:

Radiopharmaceuticals Are Showing Promise as the Next Generation of Cancer Treatment

Recent major investments signal growth in an emerging therapeutic sector.


Lisa DiSalvo

Latest:

Addressing Social Determinants of Health to Drive Member Retention, Outcomes

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.


Al Lewis, JD

Latest:

Workplace Wellness Can Be Hazardous to Your Health

The health hazards of workplace wellness programs fall within 6 categories.



Karen Kobelski, MBA

Latest:

Contributor: MA Plans Can Leverage Advanced Technology to Shore Up Risk Adjustment Practices

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.


(Howard) Po-Hao Chen

Latest:

Towards Healthcare Interoperability: What Must Be Done?

Interoperability is becoming the most sought-after in healthcare, but needs further standardization.

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