Don’t expect politicians to ride to the rescue, says the author of a book that examines just what went wrong and how we can fix it. He puts his faith in entrepreneurs, among others.
The architect of the ACA waxes defiantly about how effective the law has been and what can be done to make it more so. Also, he is OK with Medicare for all but not the Sanders version.
The executive director of the Center for Connected Health Policy talks about the promise and obstacles of embedding this technology into our lives.
The former head of CMS takes Congress to task. The ACA is not perfect (no law is) but could be improved, in his view, if only lawmakers would show more political courage.
People with behavioral health problems have stretched emergency departments to their limit as the number of inpatient psychiatric beds has decreased. For many patients, the ED is the first place they go. Even people under the care of a mental health professional wind up in EDs because they’re in crisis and their provider’s office is often closed.
Aetna’s vice president of health strategy and innovation explains how tweaking an established program will offer vulnerable beneficiaries more value.
Quantifying the worth of primary care and its delivery are essential for raising its profile. New data and payment incentives may push us closer.
The president of what started as a dental plan describes what it took to successfully launch a Medicaid ACO in the remote regions of Oregon and Alaska.
Insurer and provider come together to deliver primary and specialty care in 20 clinics. The joint venture blurs the line between stakeholders. Will patients benefit?
An MIT-led collaboration is working on a pilot project on how to pay for Zolgensma—a $2.1 million gene therapy—in installments that are contingent on the drug living up to its curative promise.
After Ohio uncovered huge spreads, other states have taken a hard look at spread pricing in their Medicaid programs. U.S. senators and CMS are also getting into the act.
Even though misunderstandings abound, now is still a good time to take the plunge and become an ACO. New CMS rules have increased the chances of financial success.
Utilization management techniques for traditional medicines don’t translate to drugs covered by the medical benefit. Site-of-service programs show some promise, though.