3 Ways Consumers are Putting the Pressure on Health Plans
The following is a guest article by Mike Pattwell, Principal Business Advisor, Value Based Care at Edifecs
Consumers are at the heart of healthcare — their fears are forcing healthcare innovators to shift priorities to deliver consumer-centric digital health offerings. This is true today, tomorrow, and far into the future.
With inflation brings financial concerns that lead to cost-cutting efforts often resulting in poorer health outcomes from millions of Americans. Consumers are looking for smarter ways to save on healthcare, forcing insurance providers to make marked changes to the way they conduct outreach and how they...
Source: EMR and HIPAA - June 21, 2023 Category: Information Technology Authors: Guest Author Tags: Communication and Patient Experience Health IT Company Healthcare IT Telemedicine and Remote Monitoring APIs Application Programming Interfaces Consumers Edifecs EHR FHIR Health Plans Healthcare Consumers Healthcare Insurance Compa Source Type: blogs
As Health Professionals Go, So Goes Our Democracy
By MIKE MAGEE
Last weekend’s New York Times headline, The Moral Crisis of America’s Doctors, spotlights that there is growing concern that the monetarization and corporatization of nursing and medical professions by hospital and insurance power houses, have seriously undermined the mental health and ethical effectiveness of health care professionals. The pandemic has only heightened the crisis.
Since focusing on the social science of Medicine in the 1990’s in Philadelphia, it has been an uphill battle to convince leaders in and out of Medicine that doctors and nurses are critical to individual and societal ...
Source: The Health Care Blog - June 19, 2023 Category: Consumer Health News Authors: matthew holt Tags: Health Policy Mike Magee physician burnout Policy/Politics Source Type: blogs
The Rise of Chat in Healthcare and Remaining Concerns
The following is a guest article by David Dyke, Chief Product Officer at Relatient
Hybrid Chat Facilitates Hands-On Patient Interaction and Eases Administrative Burden through Automation
Chat technology is beginning to be embraced by healthcare organizations to better serve patients, reduce staff burnout, increase internal efficiencies, and improve the overall patient experience. Although widely used in many other industries, its adoption is just beginning to take off in healthcare. In fact, as healthcare leaders increasingly prioritize patient access, chat’s success in other businesses has spurred the rapid onboarding o...
Source: EMR and HIPAA - June 19, 2023 Category: Information Technology Authors: Guest Author Tags: Administration AI/Machine Learning Ambulatory Communication and Patient Experience Health IT Company Healthcare IT Hospital - Health System LTPAC Administrative Burden Administrative Workflows Arkansas Children’s Hospital Auditing Source Type: blogs
What happens when Rx price bubbles (such as on insulin) burst?
In the first half of 2023, Americans witnessed evidence of a rather fundamental shift in the manner pharma had traditionally opted to commercialize selected prescription drugs. Specifically, in March 2023,Lilly,Novo Nordisk andSanofi each announced they planned to slash insulin list prices for insulin. To do so, they would disintermediate PBMs from the transaction and " opt out " of the PBM commercialization channel.The decision wasn ' t really all that difficult; for years branded insulin-makers had been complaining that PBMs and other drug distribution system entities had been gobbling up an ever-larger share of their re...
Source: Scott's Web Log - June 19, 2023 Category: Endocrinology Tags: 2023 Source Type: blogs
Privatizing Family Leave Policy: Assessing the New Opt-in Insurance Model
Deborah A. Widiss (Indiana University), Privatizing Family Leave Policy: Assessing the New Opt-in Insurance Model, Ind. L. Stud. Working Paper No. 506 (2023): Federal law fails to guarantee new parents or family caregivers paid time off from work. A growing... (Source: HealthLawProf Blog)
Source: HealthLawProf Blog - June 19, 2023 Category: Medical Law Authors: Katharine Van Tassel Source Type: blogs
A physician ’ s fight against insurance denials [PODCAST]
Subscribe to The Podcast by KevinMD. Catch up on old episodes! Join us in this compelling podcast episode as we dive into the world of insurance denials and the challenges faced by physicians and patients. Our guest, Jennifer Lycette, is not only a rural hematology-oncology physician but also a novelist and award-winning essayist. With her
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A physician’s fight against insurance denials [PODCAST] originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 17, 2023 Category: General Medicine Authors: The Podcast by KevinMD Tags: Podcast Oncology/Hematology Source Type: blogs
The cost of costs
The reason insurers impose deductibles and copays is to discourage utilization. They believe, no doubt correctly, that if people have to spend their own money they may choose not to get as many medical services or buy as many medications. The problem with this reasoning is that people aren ’t wise shoppers for medicine. Now, I’ll be the first to shout it from the rooftops that as a nation, we spend far too much on medical services that are low value or worthless. In fact, I will do so (metaphorically) later in this book. But it’s not because consumers of medicine aren’t wise s hoppers, and making them pay out...
Source: Stayin' Alive - June 17, 2023 Category: American Health Source Type: blogs
The Republican Study Committee Budget on the Key Drivers of Spending and Debt
Romina BocciaThe House and Senate both have budget committees. And yet, neither chamber has released a budget this year. Against this backdrop, it’s refreshing to see the Republican Study Committee (RSC) continue its nearly 30‐year tradition of producing an alternative conservative budget proposal. Titled “Protecting America ’s Economic Security, ” the RSC under chairman Kevin Hern (R‑OK) and Budget and Spending Task Force chairman Ben Cline (R‑VA) proposes to balance the federal budget, cut taxes, slash red tape, and boost work.The growth in the federal debt is directly tied to increases in spending for...
Source: Cato-at-liberty - June 16, 2023 Category: American Health Authors: Romina Boccia Source Type: blogs
A massive national failure
Over the decades, the U.S. has built a Rube Goldberg contraption out of employer provided health insurance, Medicare, Medicaid, the Affordable Care Act, and some smaller bits and piece that has resulted in, officially, about 90% of Americans having insurance.Great news! That means we can all afford the medical services we need and nobody has to go broke because they get sick or are injured in a car crash or shot by somebody exercising their Second Amendment rights! Err, no. Sadly it does not mean that. As a matter of fact, four out of ten insured adults surveyed in 2023 said they had skipped or delayed some type of care in...
Source: Stayin' Alive - June 16, 2023 Category: American Health Source Type: blogs
Interoperability Saves Lives and Builds Trust at HHM Health
For HHM Health, an FQHC serving the Dallas area, interoperability and access to medical records is vital for establishing trust with their patients and saving lives. The team leans on various modules from eClinicalWorks, including Prisma, which allows them to retrieve records from a variety of information exchanges – a feature that helped them save the life of new patient.
Healthcare IT Today had the opportunity to sit down with Geli Brown, Senior Director of Quality Management at HHM Health to learn more about how they are using technology to improve the lives of patients and to achieve their goal of becoming the top-ch...
Source: EMR and HIPAA - June 15, 2023 Category: Information Technology Authors: Colin Hung Tags: Ambulatory Communication and Patient Experience EMR-EHR Health IT Company Healthcare IT Carequality Cloud EHR CommonWell Health Alliance Data Sharing eClinicalWorks eClinicalWorks Prisma eCW eCW Prisma FQHC FQHCs Geli Brown Source Type: blogs
Free Download of The Capitol Forum's Report: " Exclusive Drug Dealing: Anticompetitive Practices in the Pharmaceutical Supply Chain "
In 2020, I wrote a blog post entitled " It ' s the Rx rebates, stupid! " (seehttps://blog.sstrumello.com/2020/09/its-rx-rebates-stupid.html for the post) in which I revealed the reason everyone was overpaying for insulin was because of rebating paid by insulin-makers to secure PBM formulary placement. Novo Nordisk revealed to its investors that it was spending 74% of its gross U.S. sales in the form of legally-exempted rebate kickbacks paid to PBMs. The good news is thanks to a series of actions by a number of different parties, the insulin PBM rebate price bubble finally burst whenLilly, followed byNovo Nordisk and thenSa...
Source: Scott's Web Log - June 11, 2023 Category: Endocrinology Tags: 2023 Exclusive Drug Dealing: Anticompetitive Practices in the Pharmaceutical Supply Chain report The Capitol Forum Source Type: blogs
Reducing Waste in Tests by Applying Data
See the first article in this series on lab testing and health IT.
Where doctors are reimbursed for each test, it’s well known that they order more tests than necessary. Over time, payers have tightened criteria for reimbursements. The difficult trick is to balance the value of a test against the cost, which comes out of the clinician’s bottom line.
Dr. Mukul Mehra, cofounder of Illumicare, says that many doctors, trying to track the progress of a patient, order follow-up tests that add little new information to the original test. Testing is also tiring to the patient, and repeated drawing of blood can weaken t...
Source: EMR and HIPAA - June 9, 2023 Category: Information Technology Authors: Andy Oram Tags: AI/Machine Learning Ambulatory Analytics/Big Data Clinical Health IT Company Healthcare IT Hospital - Health System LTPAC 4medica Cloudticity Gerry Miller Gregory Church Healthcare Lab Tests Healthcare Waste IllumiCare Labora Source Type: blogs
Your Health Insurance May Not Be As Good As Your State Requires — and It's Perfectly Legal
Massachusetts has a law to ensure ease of access to birth control pills, saying there should be no copays and women can fill a 12-month prescription at once. Infertility care has similar protections. But many health plans don ' t have to comply with state laws because they are“self-insured.” (Source: The RAND Blog)
Source: The RAND Blog - June 9, 2023 Category: Health Management Authors: Shira H. Fischer Source Type: blogs
The Role of Automation in Alleviating Staffing Shortages
The following is a guest article by Eric Demers, CEO at Madaket Health
The recent CWH Advisors’ 2022 Patient Pay study unearthed some troubling trends in the administration of RCM. The dearth of healthcare professionals impacting the entire healthcare industry is only adding fuel to the fire. 63% of respondents indicated that they were experiencing RCM staffing shortages, contributing to slower revenue cycles and affecting both patients and payers.
With a steady decrease in overall healthcare workers, the staffing shortages in revenue cycle departments are dire. A recent survey by Elsevier Health predicts that up to 75...
Source: EMR and HIPAA - June 8, 2023 Category: Information Technology Authors: Guest Author Tags: Administration Ambulatory Health IT Company Healthcare IT Revenue Cycle Management Administrative Burden CWH Advisors Data Management Platform DMP Elsevier Health Eric Demers Healthcare Automation Madaket Health No Surprises Act Source Type: blogs
New Evidence That Prescribing Psychologists Can Save Lives
Jeffrey A. SingerRemoving barriers to prescribing psychologists (RxPs) saves patients the inconvenience and added expense of seeing a psychiatrist or other health care practitioner that states license to prescribe psychiatric medications. Such practitioners include family physicians, nurse practitioners, physician assistants—even general surgeons like me. Now comes a study showing that it also saves lives.InEffects of Giving Psychologists Prescriptive Authority: Evidence From a Natural Experiment in the United States, researchers publishing in the journalHealth Policy used data from the National Vital Statistics Sys...
Source: Cato-at-liberty - June 7, 2023 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
