Stephen Rosenthal Explains the Future of Health Population Strategies
July 22nd 2016Stephen Rosenthal, chief operating officer of The Care Management Company at Montefiore Medical Center, said that population health strategies are the future of the health system, where networks would be responsible for the total costs of care for the population they service.
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Dr Julia Adler-Milstein Addresses the Impact of Health IT on Disparities
July 22nd 2016New health technologies will not automatically address disparities-it all depends on how those tools are used, explained Julia Adler-Milstein, PhD, assistant professor at the School of Information and the School of Public Health at the University of Michigan.
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Aparna Higgins Discusses Implementation of AHIP's New Core Sets of Quality Measures
July 21st 2016The 7 sets of core quality measures from America's Health Insurance Plans (AHIP) and CMS derived from looking at areas that were either high prevalence or high cost, said Aparna Higgins, senior vice president of Private Market Innovations and Center for Policy and Research at AHIP.
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Dr Stephen Grubbs: Value Conversation Will Go on for Years
July 21st 2016The value discussion in healthcare is becoming more relevant as the healthcare system increases its focus on better outcomes, said Stephen Grubbs, MD, vice president for clinical affairs at the American Society for Clinical Oncology.
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Dr Marcia Wilson on Addressing Quantity vs Quality for Care Measurements
July 20th 2016Marcia Wilson, PhD, MBA, senior vice president of quality measurement at The National Quality Forum, explained that one’s opinion of quality measures comes from the type of work they are in — while a primary care physician may think there are too many, a health plan could believe there’s not enough. The challenge then, she added, is filling these gaps by creating and testing new, outcome-driven measures.
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Dr Steve Miller: Innovative Payment Models Necessary to Handle Specialty Pharmacy
July 20th 2016Specialty pharmacy may be one of the most rapidly rising costs in all of healthcare, but these costs are shouldered by a small percentage of patients. As such, it is essential that new innovative payment models be developed for these new products, said Steve Miller, MD, senior vice president and chief medical officer of Express Scripts.
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Dr Helen Burstin Describes NQF's Role in the Core Quality Measures Collaborative
July 19th 2016Helen Burstin, MD, MPH, FACP, chief scientific officer of The National Quality Forum, said that quality measurement is at the core of transitioning to value-based payment, and that the initiative can’t truly move forward without putting the work in to identify and define what that value is.
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Karen Ignagni Discusses the Sustainability of the ACA
July 19th 2016Sustainability in the Affordable Care Act marketplaces will occur when the health plans and the providers come together to establish both cost and quality goals and work together to achieve them, explained Karen Ignagni, president and CEO of EmblemHealth.
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Jeb Dunkelberger: Value-Based Organizations Are Here to Stay
July 18th 2016Although the term "accountable care organization" (ACO) may not be here to stay, value-based organizations are here to stay based on the direction CMS is headed, said Jeb Dunkelberger, vice president of accountable care services at McKesson and clinical & commercial operations at ACO Partner.
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Dr Niteesh Choudhry Highlights How HDHPs Can Benefit From VBID
July 18th 2016There are desirable and undesirable effects of high-deductible health plans, and the use of value-based insurance design may mitigate adverse effects of these plans, explained Niteesh Choudhry, MD, PhD, associate professor of medicine at Harvard Medical School.
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Dr Aimee Tharaldson: Orphan Drugs Will Remain A Lucrative, Growing Business
July 17th 2016Orphan drugs are a very lucrative business, and Aimee Tharaldson, PharmD, senior clinical consultant of emerging therapies at Express Scripts, expects to see more orphan drugs reach market as manufacturers focus their development efforts in these areas.
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Dr Debra Patt Breaks Down Rising Cancer Care Costs
July 15th 2016Although cancer care costs are rising, it is proportional to the total utilization of healthcare resources and spending growth is happening more in areas that have seen innovation, explained Debra Patt, MD, MPH, MBA, director of public policy at Texas Oncology.
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Bernard J. Tyson Discusses Kaiser Permanente's Emerging New Medical School
July 14th 2016With the development of Kaiser Permanente’s new medical school comes an emerging philosophy to more directly align medical education with the industry’s current transition to more integrated, holistic approaches to care, said Bernard J. Tyson, chairman and CEO of Kaiser Permanente.
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Dr Lonny Reisman: It's Time to Take Advantage of Big Data in Healthcare
July 14th 2016Incorporating big data is essential as it can help explain failures in medical practice, accumulate patient information, and perform a variety of other useful functions, explained Lonny Reisman, MD, CEO of HealthReveal.
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Stephen Nuckolls Emphasizes the Importance of Transparency in ACO Benchmarks
July 13th 2016While speaking at the National Association of Accountable Care Organizations Spring 2016 Conference, Stephen Nuckolls, CEO of Coastal Carolina Quality Care, said that fair and transparent benchmarks are important in creating successful ACO programs.
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Erica Hutchins Coe Discusses the Future of the ACA Health Insurance Markets
July 13th 2016While some insurers are questioning the sustainability of the Affordable Care Act health insurance markets, Erica Hutchins Coe, partner and co-leader of Center for US Health System Reform at McKinsey & Company, said that carriers continue to see new entrants on their exchanges, which she believes makes for a promising future.
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Dr Joe Antos Discusses Areas of Improvement Within the ACA
July 12th 2016Though the implementation of the Affordable Care Act has introduced various beneficial provisions for the American public, Joe Antos, PhD, the Wilson H. Taylor Scholar in Health Care and Retirement Policy at the American Enterprise Institute, said that he still sees room for improvement.
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Dr Karen van Caulil Explains the Benefit of an All-Payer Claims Database
July 12th 2016A statewide all-payer claims database would permit more insight into what’s happening with cost and quality of providers, and possibly transform healthcare payment, explained Karen van Caulil, PhD, president and CEO of the Florida Health Care Coalition.
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Jay Sheehy on the Different Ways of Engaging Consumers in the Marketplace
July 11th 2016Jay Sheehy, senior vice president of product innovation at EmblemHealth, explained that being able to tailor your message to specific patient populations will help to better engage consumers, which will prove to be more successful for healthcare companies in the long term.
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Dr Farzad Mostashari: ACOs Could Face Patient Backlash
July 11th 2016One of the biggest concerns Farzad Mostashari, MD, chief executive officer of Aledade, has about accountable care organizations, is that they are going to experience backlash similar to what managed care has received in the past.
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Dr Steven Pearson on the Education of Value Frameworks Among Physicians
July 10th 2016While discussion of value frameworks has grown in academic and policy meeting settings, physician education on the subject is still in its very early stages, said Steven D. Pearson, MD, MSc, president of the Institute for Clinical and Economic Review.
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Dr Kelly Clark Describes How Payers Can Increase Patient Access to Medication-Assisted Therapy
July 8th 2016According to Kelly J. Clark, MD, MBA, president elect of the American Society of Addiction Medicine, payers and pharmacy benefit managers can aid in patient access to the medication they need to treat addictive disease by ensuring an evidence-based prior authorization protocol, just as they would for a patient with a chronic disease.
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Dr Michael Kolodziej Explains the Benefits of Aetna's Oncology Medical Home Program
July 7th 2016Michael Kolodziej, MD, national medical director for oncology strategy at Aetna, said that the evaluation of academic medical centers has allowed the company to examine what lies at the heart of creating optimal patient outcomes and experiences.
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Marilyn Tavenner Explains Methods of Implementing, Coordinating Quality Measures
July 6th 2016The key in developing core sets of quality measures is looking at coordination of care, cost of care, and quality of care, as methods that all work simultaneously together, explained Marilyn Tavenner, president and CEO of America’s Health Insurance Plans. However, she added that creating a small amount of measures centered upon core conditions and directly tied to outcomes is far more beneficial than creating a hundred new measures.
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Aparna Higgins Explains Significance of AHIP's Core Quality Measures
July 5th 2016Aparna Higgins, senior vice president of Private Market Innovations and Center for Policy and Research at America’s Health Insurance Plans (AHIP), explained that CMS and AHIP’s recent release of set core quality measures was an effort to help harmonize the varying types of measures that already exist as well as to focus in on quality improvement efforts.
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Dr Alan Balch Discusses the Value in Patient-Centered Stakeholder Conversations
July 4th 2016According to Alan Balch, PhD, CEO of the Patient Advocate Foundation, having a common language that is centered on the patient is crucial when stakeholders come together with various value frameworks. Ultimately, he said it’s these value frameworks that are going to steer the patients in one way or another.
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