Blue Shield of California (BSC) created its Wellvolution platform, a collection of wellbeing apps, with the intention of helping members with their diet, exercise, sleep and overall health. But until last month, it has…
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Ashish Kachru, CEO, DataLinkThe new healthcare realm of value-based care (VBC), designed to reward healthcare providers with incentive payments for the quality of care and patient outcomes not simply the volume of services provided,…
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Top News
ONC publishes “Social Determinants of Health Information Exchange Toolkit.”
Reader Comments From NY CIO: “Re: Northwell Health. Word is it will announce its move to Epic and that it will bring a large…
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BroadbandOhio, a division of the Ohio Department of Development, selected OCHIN as its statewide telehealth administrator to help expand healthcare services for Ohio’s K-12 students.WHY IT MATTERS
The new initiative aims to help administrators in…
A recent study showed that rates of follow-up care are lacking among children with mental health emergencies, underscoring the need for stronger patient engagement after hospitalization. These findings come in the midst of the…
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Amid swirling accusations that Medicare Advantage Organizations (MAOs) are overbilling the U.S. government and calls for better oversight, the Centers for Medicare & Medicaid Services announced in early February that it would investigate overbilling by those plans. They expect to recoup 4.7 billion dollars through this program.
This article focuses on the relatively young technologies that enable CMS to uncover overbillings, whether they be errors or fraud. The article is based on an interview with Kel Pults, chief clinical officer and vice president of MediQuant. A future article will explain how Medicare Advantage plans are trying to improving data collection and reporting,…
The public health emergency declared in early 2020 was put in place to provide waivers from the Centers for Medicare and Medicaid Services to ease the burden on hospitals and other providers during the pandemic. It has been extended 12 times since its implementation and is finally slated to end on May 11. Heather Meade, principal at Washington Council Ernst & Young, spoke with MobiHealthNews about how the end of the PHE could affect telemedicine companies’ funding streams and patients’ access to care.
MobiHealthNews: What are the benefits and detriments to the PHE ending, especially for telehealth?
Meade: I mean, we need permanent policy…
With the Inflation Reduction Act now on the books, the U.S. Centers for Medicare & Medicaid Services (CMS) will begin negotiating drug prices with the pharmaceutical industry. That, combined with other headwinds such as increased competition from me-too drugs, and ever-present pricing pressure from payers, means that pharma players now more than ever need a new and powerful tool to differentiate their products. We believe the next decade of transformation is digital.
Learning from the auto industry Almost every industry has had to confront a fundamental existential question: What is our product? Consider the automotive industry, which once was largely about hardware…
The U.S. Department of Health & Human Services (HHS) unveiled three new models Tuesday that will be tested by the CMS Innovation Center and aim to lower prescription drug costs. The models include access to $2 generic drugs.
The news is in response to President Joe Biden’s executive order issued in October, which directed HHS to find ways to lower prescription drug costs and improve access to drug therapies for those enrolled in Medicare and Medicaid health plans. The models are meant to build on the Inflation Reduction Act of 2022, which includes allowing Medicare to negotiate lower prescription drug prices for…
Just about one-third of managed care plans have verified or current contact information for between 76% and 100% of their Medicaid members, a recent survey found.
The news comes as the Medicaid continuous enrollment provision is set to expire March 31 due to the Consolidated Appropriations Act. The requirement was part of the Families First Coronavirus Response Act and banned states from disenrolling people from Medicaid during the public health emergency (although the Consolidated Appropriations Act separated the requirement from the PHE, which will end in May). Starting April 1, states can resume disenrollments and Medicaid enrollees will have to undergo the…
