Care Management


CMS has finalized a rule for a bundled payment test for hip and knee replacements that will be mandatory for nearly all hospitals in 67 geographical areas across the country.
In a session at the Fall Managed Care Forum 2015, in Las Vegas, Nevada, cardiology expert Harold Bays MD, FTOS, FACC, FACE, FNLA, emphasized the importance of greater adherence to evidence-based practice guidelines, and the relevance of treatment with omega-3 fatty acids in hypertriglyceridemia.
Clinicians consider a number of patient predisposing and enabling characteristics not typically available in clinical data systems when selecting high-risk patients for care management.
While care models are being designed to improve outcomes and reduce costs for complex needs patients, there is only modest evidence of their impact and there are a number of barriers to wider adoption of these care models in practice.
The pay-for-performance model has come a long way in terms of how physicians are taking care of larger patients populations, according to Mitzi Wasik, PharmD, BCPS, director of Pharmacy Medicare Programs at Aetna, Inc.


October 17 - 18, 2014
Boston, MA
Diabetes Compendium
Oncology Compendium