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Partnering With Providers to Prevent or Delay Complications Related to Diabetes
John A. Johnson, MD, MBA: The microvascular complications of diabetes include anything from effects on [a patient’s] blood pressure, peripheral neuropathy, the ability to have abnormalities in their sensation (in their hands and feet), and blindness. Macrovascular complications include cardiovascular effects such as heart attacks, stroke, and end-stage kidney disease.
So we look at ways that we can, in a preventative approach, reduce those complications because, as we’ve seen at WellCare, in patients who don’t have access to care—either inadequate access or lack of behavioral modification in lifestyle changes—a negative impact in their outcomes is seen.
We work with the provider community to make them aware of the members that they have within their care—that are WellCare members—and [figure out] how we can partner with them and equip them with tools to enhance the care of diabetics to prevent or delay the onset of these micro- and macrovascular complications.
AI in Health Care: Closing the Revenue Cycle Gap
April 1st 2025This commentary explores the current state, challenges, and potential of artificial intelligence (AI) in health care revenue cycle management, emphasizing collaboration, data standardization, and targeted implementation to enhance adoption.
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Managed Care Reflections: A Q&A With Hoangmai H. Pham, MD, MPH
April 1st 2025To mark the 30th anniversary of The American Journal of Managed Care® (AJMC®), each issue in 2025 will include a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The April issue features a conversation with Hoangmai H. Pham, MD, MPH, a member of AJMC’s editorial board and the president and CEO of the Institute for Exceptional Care (IEC).
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Bridging Care Gaps With a Systemwide Value-Based Care Strategy
March 29th 2025Mapping care management needs by defining patient populations and then stratifying them according to risk and their needs can help to spur the transformation of a siloed health care system into an integrated system that is able to better provide holistic, value-based care despite the many transitions that continue among hospital, primary, specialty, and community care environments.
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