These eight questions show that the use of an LBM or a PAP should be just one of the potential results of your laboratory benefit management program, not the program itself. You shouldn’t have to pay for services you already provide yourselves or add a middleman that’s not necessary.
The number of children ages 1 to 17 admitted to hospitals for an overdose of opioids nearly doubled from 797 patients between 2004 and 2007 and 1,504 between 2012 and 2015. The oldest children in the study in Pediatrics, those between 12 and 17, accounted for over 60% of patients admitted for opioid overdose.
The CMO of Molina Healthcare of Utah grew up, let’s say, not rich. He says that and a varied background—including a stint in the Air Force—helps him deal with changing policies involving a challenging population.
Sometimes patients are angry. Sometimes it is a symptom of their illness. Either way, nurses are on the front lines of health care and bear the brunt of the physical and verbal abuse from patients; gender may be a factor. In California, hospitals and other health care providers are now required to keep a log of violent incidents and develop violence prevention plans. Federal legislation has been introduced.
Diabetes is the scourge of our times, but we have been chasing the wrong culprits. A simple, $40 test of insulin resistance could put us on the right track.
Thirty-nine states had contracts with comprehensive risk-based Medicaid managed care organizations and in 29 of those states, 75% or more of the Medicaid beneficiaries were enrolled in one of those organizations. A large majority (27 of 32) of the Medicaid expansion states used managed care organizations to cover newly eligibly adults.
Some hospitals are making house calls these days as they experiment with delivery of high-intensity care in people’s homes. Taking the hospital out of hospitalization might be safer and less expensive than conventional inpatient care. Median direct costs of the home patients were half that (52% lower) of the control patients who received conventional hospital care.
The deadliness of liver cancer is undisputed, but a growing body of data shows that too often, patients, and particularly those who are uninsured or nonwhite, miss out on earlier diagnosis and potentially life-saving surgery.
The architects of Medical Episode Spending Allowance benefits are radically reframing coverage as allowances for episodes of care and have a plan for engaging members in making better choices.
Cancer survivors were better able to afford care and did not see delays in treatment from 2010 through 2016, the years when the ACA was phased in. But researchers were unable to make a definite connection because many of the ACA’s coverage changes did not come about until January 2014.