Stephen Rosenthal on Penalty Programs for Hospital Readmissions
July 1st 2016For as much as penalty programs for hospital readmissions have created challenges, they’ve also created awareness, said Stephen Rosenthal, chief operating officer of The Care Management Company at Montefiore Medical Center.
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Jay Sheehy Explains How Health Plans Can Better Engage Consumers
June 30th 2016It is important that health insurers fully understand the populations and demographics they are working with in order to effectively engage their consumers, said Jay Sheehy, senior vice president of product innovation at EmblemHealth.
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The Pace of Healthcare Transformation to a Value-Based System
June 29th 2016More insurers are moving towards alternative payment and delivery models, but the transition needs to happen a lot quicker, explained Michael E. Chernew, PhD, during a panel discussion at the ACO & Emerging Healthcare Delivery Coalition Spring Live Meeting.
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Stephen Nuckolls Explains the Importance of Physician Buy-In for ACOs
June 28th 2016In order to get physicians engaged and involved in accountable care organizations (ACOs), it is important to educate them on the mission and understand that the organization is looking to improve, not ration, care, Stephen Nuckolls, CEO of Coastal Carolina Quality Care, explained at the National Association of Accountable Care Organizations Spring 2016 Conference.
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Dr Renee Arnold Discusses Genomics and Budgetary Impact Modeling
June 27th 2016Genomics are important in determining cost effectiveness because they ensure that the right agents are being used on the patients for which the treatment was intended, explained Renee JG Arnold, PharmD, RPh, practice lead for health economics and outcomes research at Quorum Consulting, Inc.
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Dr Joe Antos Outlines AEI's Proposal for Improving Healthcare in the US
June 26th 2016The American Enterprise Institute (AEI) released its own plan for making improvements to the healthcare system, which included ideas such as premium support for Medicare, explained Joe Antos, PhD, the Wilson H. Taylor Scholar in Health Care and Retirement Policy at AEI.
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Dr Toby Campbell: Palliative Care Discussions Are Difficult, but Necessary
June 24th 2016Bringing up palliative care is inherently difficult for providers, because it means bringing up death and dying, said Toby C. Campbell, MD, MSCI, associate professor of medicine, hematology-oncology at the University of Wisconsin School of Medicine and Public Health.
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Marilyn Tavenner: Affordability the Biggest Challenge Facing Insurers
June 23rd 2016According to Marilyn Tavenner, president and CEO of America’s Health Insurance Plans, consumer and provider education plays a large role in the healthcare system’s transition to alternative payment-models and value-based care. Affordability is the operative word, for which Tavenner expects to be insurers biggest challenge in the coming future.
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Dr Karen van Caulil Discusses the Importance of Data Sharing
June 23rd 2016Healthcare informatics have improved education programs and initiatives as patient data becomes more open. However, data should be more widely shared, especially between employers and clinical providers, in order to better eliminate barriers to care access, said Karen van Caulil, PhD, president and CEO of the Florida Health Care Coalition.
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Jennifer Sullivan Discusses Active Consumer Re-Enrollment
June 22nd 2016Consumers should be actively engaged with their health coverage, so they will not only be informed of fines that may incur if they do not enroll, but also so that they are also aware of any new plans for the coming year that may best fit them and their family, said Jennifer Sullivan, director of the Best Practices Institute at Enroll America.
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Erica Hutchins Coe Explains the Impact of the ACA on Health Plans
June 21st 2016Since the implementation of the ACA, health plans have been moving towards more managed, narrower plans. In addition, Erica Hutchins Coe, partner and co-leader of Center for US Health System Reform at McKinsey & Company, said that she has seen a progression of younger, healthier adults moving into the marketplace.
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Dr Lee Schwartzberg Discusses Side Effects of Checkpoint Inhibitors in Breast Cancer
June 20th 2016Lee Schwartzberg, MD, FACP, chief of Division of Hematology Oncology and professor of medicine at the University of Tennessee Health Science Center, discusses side effects seen with PD-1 and PD-L1 inhibitors as well as the recent USPSTF screening recommendations for breast cancer.
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Dr Steven Pearson: No Silver Bullet to Constrain Drug Prices
June 17th 2016There is no silver bullet when it comes to implementing policies to constrain drug prices, but a value-based price approach will be essential, said Steven Pearson, MD, MSc, FRCP, founder and president of the Institute for Clinical and Economic Review.
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Bernard J. Tyson Highlights Progress, Hurdles in the Move to Value-Based Care
June 16th 2016As the United States healthcare system moves to value-based care, there have been clear signs of progress when it comes to better aligning incentives, but affordability remains a hurdle that needs to be overcome, said Bernard J. Tyson, chairman and CEO of Kaiser Permanente.
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Dr James Whitfill on Assisting Patients With Social Needs
June 16th 2016Scottsdale Health Partners helps patients with social needs through a complex care coordination program and working with community resources like adult protective services or other city government branches, James Whitfill, MD, chief medical officer, explained at the National Association of ACOs Spring 2016 Conference.
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Brian Marcotte Describes the Challenge of Value-Based Purchasing
June 15th 2016It’s crucial for accountable care organizations to not only understand what value-based purchasing is, but for everyone to be on the same page as far as the expectations involved and what exactly it takes to get there, said Brian Marcotte, president and CEO of The National Business Group on Health.
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Dr Steve Miller Weighs Pros and Cons of Medicare Part B Proposal
June 14th 2016The new Medicare Part B proposal from CMS has been controversial, and Steve Miller, MD, senior vice president and chief medical officer of Express Scripts, understands both sides of the argument. While he appreciates CMS' dedication to innovation, the demonstration may drive up payer costs.
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Karen Ignagni on EmblemHealth's Transition to Value-Based Payments
June 13th 2016Karen Ignagni discusses taking over EmblemHealth and implementing a turnaround after the company experienced net losses of more than $485 million in 2014, as well as the healthcare industry's transition to value-based payment.
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Dr Julia Adler-Milstein Describes the Challenges of Data Gathering
June 12th 2016Julia Adler-Milstein, PhD, assistant professor at the School of Information and the School of Public Health at the University of Michigan, describes the challenges of data gathering, and ensuring not only that the data is accurate and complete, but that the patient can use that data and ultimately lead a healthier lifestyle with that knowledge.
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Dr Aimee Tharaldson Expects the Biosimilar Approval Process to Pick Up Speed
June 10th 2016The process for approving biosimilars has been moving slowly, but Aimee Tharaldson, PharmD, senior clinical consultant of emerging therapies at Express Scripts, foresees them as having the potential to lower costs for the industry and hopes the approval process will pick up speed.
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Dr Kelly Clark Discusses Challenges of Accessing Opioid Addiction Treatment
June 8th 2016With only 3 medications FDA-approved to treat opioid addiction, patient access to these treatment options can be difficult, and each medication presents its own challenges, said Kelly J. Clark, MD, MBA, president elect of the American Society of Addiction Medicine.
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Anne Jessup Explains Florida Blue's Changes Since ACA Implementation
June 6th 2016Since the implementation of ACA, Florida Blue’s enrollment plans have changed in that plan has expanded its outreach platforms and had to educate a larger audience of consumers, explained Anne Jessup, senior director of digital channels at Florida Blue.
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Dr Farzad Mostashari Explains the New ACO Benchmarking Rule
June 1st 2016The new accountable care organization (ACO) benchmarking rule changes it so ACOs aren't just competing against themselves and transitions so ACOs have to be better than others in their region, Farzad Mostashari, MD, chief executive officer of Aledade, explained at the National Association of ACOs Spring 2016 Conference.
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Dr John Bennett on Slowing Rising Drug Costs
May 31st 2016In order to slow the rising costs of prescription drugs there has to be a greater emphasis on value-based payments, on transparency, and on the consumer, perhaps even with the government’s help, said John Bennett, MD, FACC, FACP, president and CEO of CDPHP.
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Dr Niteesh Choudhry Discusses the Pros and Cons of HDHPs
May 29th 2016High-deductible health plans have a role to play, but it's important that they aren't used in such a way as to create a disincentive of the use of a consumer's benefits, said Niteesh Choudhry, MD, PhD, associate professor of medicine at Harvard Medical School.
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Dr Sophia Smith Discusses Attending to Patients' Psychosocial Needs
May 27th 2016Having psychosocial support for patients with cancer, and for their family members, is critical, because patients often feel that their emotional needs are overlooked in busy clinics, said Sophia K. Smith, PhD, MSW, associate professor at the Duke School of Nursing.
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