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Hospitals Look To Become Insurers, As Well As Providers Of Care
Michael Dowling, a burly Ireland native running one of New York’s largest hospital networks, is preparing to turn his business model on its head: He wants to keep his hospital beds empty, rather than full.
That’s because the North Shore-LIJ Health System, with 16 hospitals and more than 300 outpatient centers in Long Island and New York City, is laying the groundwork to be an insurer, as well as a provider of health care.
Like other hospital chains across the country, it’s under intense pressure from public and private insurers, as well as employers, to accept flat-rate payments for care, rather than reimbursements for every service. And that puts pressure on hospitals not just to manage costs, but to keep people well — in short, to act more like insurers.
Read the full story: http://tinyurl.com/9fkxqv4
Source: Kaiser Health News
Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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Dual Therapy Appears to Benefit Patients With Pulmonary Fibrosis, Pulmonary Hypertension
May 15th 2025The combination of antifibrotic therapy and pulmonary vasodilator therapy improved transplant-free survival but had no significant impact on exercise capacity in pulmonary fibrosis and pulmonary hypertension.
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