Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Chronic Disease Management

PCPs, Psychiatrists Much Less Likely to Accept Medicaid

February 6, 2019 - Primary care providers (PCPs) and psychiatrists are among the least likely professionals to accept Medicaid, leaving patients without some of the most fundamental resources for preventing or managing chronic diseases, according to recent data compiled by MACPAC. The Medicaid and CHIP Payment and Access Commission found that only 68 percent of general practice or family physicians...


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Price of Insulin Doubles, Increasing Spending for Members, Payers

by Jennifer Bresnick

Dramatic increases in the price of insulin are driving a rapid uptick in overall spending for diabetes care, according to new data from the Health Care Cost Institute (HCCI). Between 2012 and 2016, the point of sale price for insulin...

Apple Floats Idea of Subsidizing Watches for Medicare Advantage

by Jennifer Bresnick

Apple has approached several Medicare Advantage plan providers to discuss the idea of subsidizing its Apple Watch for at-risk seniors, according to industry reports. CNBC reporter Christina Farr states that at least three Medicare...

ACA, Member Engagement Challenges Led Top 10 Stories of 2018

by Jennifer Bresnick

It’s fair to say that the health payer community had a lot to process in 2018.  Mergers, partnerships, and new entries into the field rocked the traditional industry setup, while federal efforts to chip away at the Affordable...

High-Deductible Plans Lead Diabetics to Forgo, Delay Treatment

by Chuck Green

Workers with diabetes who switched to high-deductible health plans requiring additional out-of-pocket expenses are more apt to put off necessary check-ups, a new Annals of Internal Medicine study finds. A growing proportion of Americans...

Payers Can Leverage Telehealth for Chronic Disease Management

by Thomas Beaton

Telehealth offers a cost-effective way to improve member satisfaction with benefits and support meaningful chronic disease management, according to a new report from AHIP and the Coalition to Transform Advanced Care (C-TAC)....

Top Health Plans Excel in Preventive Care, Chronic Disease Management

by Thomas Beaton

Health plans that offered high-quality preventive care and comprehensive chronic disease management received top marks in the latest health plan rankings from the National Committee on Quality Assurance (NCQA). NCQA ranks health plans in...

Top 10 Highest Performing Medicare Advantage Health Plans

by Thomas Beaton

Medicare Advantage (MA) plans are growing in popularity as an aging consumer population seeks comprehensive coverage for acute and chronic care needs. A competitive, lucrative market for high-performing plans has emerged, giving payers an...

How to Improve Cost Sharing to Enhance Chronic Disease Management

by Thomas Beaton

A tailored cost sharing program that helps beneficiaries pay for chronic disease care can reduce wasteful spending and increase access to chronic disease management services. However, relying on one-size-fits all cost-sharing plans can...

How to Address Medicare Advantage Beneficiary Disenrollment

by Thomas Beaton

Medicare Advantage is a growing market and an attractive opportunity for payers to offer quality plans to older beneficiaries.  Competition is increasing in the MA environment, and beneficiaries have more options than ever to meet...

10% of Medicare Advantage Members Receive Chronic Care Reminders

by Thomas Beaton

Only 10 percent of Medicare Advantage (MA) and Medigap plan members receive chronic care management reminders,, according to a new survey from Healthmine. The CDC estimates that 70 percent of all Medicare beneficiaries have at least one...

How Payers Can Address Food Insecurity among Plan Beneficiaries

by Thomas Beaton

Payers are constantly challenged to provide their health plan beneficiaries the best possible healthcare experiences, but may have trouble doing that if members experience food insecurity. Food security is just one lifestyle need that...

Medicare Diabetes Prevention Program Offers Model for Chronic Care

by Thomas Beaton

CMS’s Medicare Diabetes Prevention Program (MDPP) aims to address diabetes prevalence within the Medicare program, and may help other payers develop a model for chronic care, based on the MDPP’s promising initial...

Medicare Wellness Programs Promise Better Health Outcomes

by Thomas Beaton

Medicare wellness programs have the potential to improve physical and mental health for beneficiaries with chronic conditions, according to a new report from the Center for Medicare and Medicaid Innovation (CMMI). Medicare members that...

Employers, Employees Face Disconnect Over Wellness Programming

by Thomas Beaton

More than half of employers believe that their wellness programming is effective for improving health and reducing spending, but only a third of their employees think the same thing, according to a new Willis Watson Towers...

Top 10 Highest Performing Medicare, Medicaid Health Plans

by Thomas Beaton

The top-performing Medicare and Medicaid health plans for the 2017-18 plan year earned exceptional quality scores based on the plans’ customer satisfaction, preventive care, and treatment outcomes of beneficiaries, according to the...

Payers Support Integrated Care Services for NC Medicaid Patients

by Thomas Beaton

Payers and provider organizations that support integrated care systems can help lower healthcare costs by addressing the healthcare concerns of vulnerable patient populations, including Medicaid beneficiaries. Several commercial payers...

How Payers Address the Four Domains of Chronic Disease Prevention

by Thomas Beaton

Payers have an opportunity to improve chronic disease prevention and limit chronic disease spending by addressing the both medical and non-medical factors of chronic conditions. Payers can determine their chronic disease costs, and lower...

61% of Employees Dissatisfied with Employer Wellness Programs

by Thomas Beaton

Fifty-two percent of employers believe their wellness programs improve their employee’s health behaviors, but only 32 percent of employees agree, according to a new survey from Willis Towers Watson. More than 60 percent are actively...

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