Blue Health Intelligence attempts to paint a fuller picture of ‘what went wrong’ by limiting exclusions.
PBMs and insurers are getting rolled into single entities with clout over the supply chain and benefit design. Any major changes in how they operate may wait as they spend 2019 figuring out how to mesh.
Population health service organizations (PHSOs) are supplanting management service organizations that gained popularity in the ’90s. PHSOs are emerging as the organizations within health systems that can improve the clinical and financial outcomes of the populations the health systems serve.
CMS wants to encourage broader use of telehealth by updating methods of payment and the amount paid to MA plans and their providers. Under the proposed rule, Medicare would pay doctors $14 for a five-minute call to patients. If enacted, the changes would take effect starting in 2020.