March 20th 2024
For more than a decade, certain high-value preventive care services have been covered at no cost to patients under the Affordable Care Act, but a current legal challenge has the coverage at risk.
New Research Calls for a Reconsideration of Loop Diuretic Use, Fluid Restriction in HF
May 25th 2022Thirst outcomes were investigated among patients with stable heart failure (HF), due to the limited data available on this relationship and how it, along with fluid and sodium intake, influences clinical outcomes in this population.
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Neil Goldfarb Previews Theme, Potential Takeaways of 2022 GPBCH Annual Conference
May 18th 2022Neil Goldfarb, president and chief executive officer of Greater Philadelphia Business Coalition on Health (GPBCH), provides an overview of the core discussion points and other aspects in-person attendees can look forward to at the 2022 GPBCH Annual Conference.
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Contributor: The Convergence of Value-Based Care and Lab Testing Growth
May 17th 2022Today, health plans are shifting dollars to more value-based contracts along with investments in population health management. Digitizing lab results across all care settings and unlocking the potential of lab values can help health plans reach the Triple Aim of improving the patient experience, improving the health of populations, and reducing the per-member cost of health care.
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Physician Prices and Low-Value Services: Evidence From General Internal Medicine
This study found extensive variation in general internal medicine physician prices and that high-priced physicians provided fewer low-value services but had higher spending on these services.
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Assessing Surveillance Utilization and Value in Commercially Insured Patients With Colorectal Cancer
May 10th 2022Trends in surveillance testing after treatment for colorectal cancer remained relatively stable recently, and patients who overutilized surveillance measures had quicker recurrence detection but higher costs.
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Taking Action Against the Rising Mental Health Crisis: Efforts From Health Plans, Congress, and More
May 10th 2022Marking Mental Health Awareness month, stakeholders involved in the delivery of behavioral health care services discuss current efforts underway—spearheaded by the novel 988 emergency hotline—to address the growing mental health crisis.
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Integrating Analytics With High-Touch Pharmacy Care for Vulnerable Beneficiaries
May 8th 2022UPMC Health Plan, RxAnte, and Mosaic Pharmacy Services outlined how they are operating a value-based pharmacy care management program within Community HealthChoices, Pennsylvania’s managed Medicaid long-term services and supports (LTSS) program, at a recent conference.
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Contributor: Helping Women of Color Achieve a Healthier Future
April 27th 2022To achieve health equity, experts from CVS Health discuss why we must invest in programs that improve access to health care for historically marginalized communities, address social determinants, boost health education, increase representation in all levels of health care delivery, widen access to clinical trial research, and more.
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Nathan H. Walcker on Expectations for Stakeholders Attending Tampa IVBM Meeting
April 27th 2022Nathan H. Walcker, MBA, chief executive officer, Florida Cancer Specialists & Research Institute (FCSRI), discusses what guests can expect at the in-person Tampa meeting of The American Journal of Managed Care®'s Institute for Value-Based Medicine® (IVBM), co-hosted by FCSRI.
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Dr Michael Diaz Previews In-person Tampa IVBM Meeting
April 26th 2022Michael Diaz, MD, president and managing physician, Florida Cancer Specialists & Research Institute, previews the Tampa meeting of The American Journal of Managed Care®'s Institute for Value-Based Medicine® (IVBM), cohosted by Florida Cancer Specialists & Research Institute.
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Changes in Use of Low-Value Services During the COVID-19 Pandemic
April 22nd 2022Use of low-value care services during COVID-19 exhibits substantial heterogeneity but, on average, shows declines similar to the use of high-value services; low-value care use lags behind high-value care use in the rebound phase.
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Incremental Steps Helpful but Not Enough to End Underinsurance Issue, Panelists Say
April 7th 2022Without addressing rising costs, the problem of underinsurance in health care coverage will remain, said panelists at the 2022 V-BID Summit, discussing some of the smaller steps that are being proposed or are already in place to try to ease the financial burden.
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Increasing Health Equity to Reduce Disparities in Value-Based Care
April 7th 2022At the 2022 V-BID Summit, hosted by the Center for Value-Based Insurance Design at the University of Michigan, representatives of CMS and the Commonwealth Fund gave an update on the efforts to monitor, evaluate, and improve health equity in the United States.
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Dr Dennis Scanlon on Barriers for Learning Health Care Systems
April 6th 2022Dennis P. Scanlon, PhD, professor of health policy and administration at Pennsylvania State University and editor-in-chief of The American Journal of Accountable Care®, talks about major systemic and fundamental barriers to health systems becoming learning health systems.
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Dr Crystal Zhou Discusses Incorporating Pharmacists Into the Cardiology Care Team
April 5th 2022Patients who cardiologists see once every few months are getting handed over to pharmacists who can monitor them more frequently and get them to their goals, said Crystal Zhou, PharmD, assistant professor of Clinical Pharmacy at the University of California, San Francisco (UCSF).
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Angela Storseth-Cooper Describes PBM Influence in Community Oncology, State-Level Interventions
March 24th 2022Angela Storseth-Cooper, associate director, Government Relations & Public Policy, The US Oncology Network, discusses state-level legislation that community oncology practices can leverage to address issues involving pharmacy benefit managers and the vertical integration of health plans and specialty pharmacies.
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Dr Lalan Wilfong Addresses Influence, Future Use of HEOR in Community Oncology
March 18th 2022Lalan Wilfong, MD, vice president of Payer Relations & Practice Transformation at The US Oncology Network, speaks on how use of health economics and outcomes research has benefitted patient care in the community oncology setting and where it can be further leveraged in the pursuit of value-based care.
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Experts Discuss How Employers Can Take on HSA HDHP Challenges While Encouraging Value-Based Care
February 20th 2022Speaking during a webinar presented by the National Alliance of Healthcare Purchaser Coalitions, experts weighed the pros and cons of employer high-deductible health plans (HDHPs) and outlined steps to address challenges raised.
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Dr Dennis Scanlon Discusses End-of-Year Letter on Health Care Innovation
February 18th 2022Dennis P. Scanlon, PhD, professor of health policy and administration at Pennsylvania State University and editor-in-chief of The American Journal of Accountable Care, discusses his 2021 end-of-year letter calling on health system leaders to learn and innovate in real time.
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Dr Kenneth Cohen: Low-Value Care Exists Across the Health Care System
February 15th 2022Kenneth Cohen, MD, FACP, executive director of clinical research at UnitedHealth Group Research and Development and senior national medical director at OptumCare, discusses areas where low-value care is more prevalent and the shift to high-value care.
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Dr Kenneth Cohen on Education, Tools to Reduce Low-Value Care
February 10th 2022Kenneth Cohen, MD, FACP, executive director of clinical research at UnitedHealth Group Research and Development and senior national medical director at OptumCare, discusses evidence-based education and other tools to address low-value care.
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Number of Accountable Care Organizations Joining MSSP in 2022 Grew Slightly, CMS Says
January 26th 2022In its annual Medicare Shared Savings Program (MSSP) report, CMS said the number of accountable care organizations joining increased, but a trade group said the results should have been better.
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