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Managed Care

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https://www.readbyqxmd.com/read/28511770/federal-per-capita-funding-of-medicaid-deals-a-wild-card-to-the-states
#1
(no author information available yet)
Since its inception, the federal government has financed a certain percentage of Medicaid expenditures. The American Health Care Act would ditch the percentage funding and replace it with a set amount per Medicaid beneficiary. The bill calls for using each state's spending in 2016 as the base year to arrive at the per Medicaid beneficiary amount.
April 2017: Managed Care
https://www.readbyqxmd.com/read/28511769/book-review-ahca-s-small-government-bona-fides
#2
Peter Boland
From Obamacare to Trumpcare: Why You Should Care by Harry Nelson and Rob Fuller challenges the policy of both Democrats and Republicans. It explains how our country is so ideologically polarized that a consensus on health care is unlikely to emerge for the foreseeable future.
April 2017: Managed Care
https://www.readbyqxmd.com/read/28511768/telemedicine-seems-to-work-but-payment-creates-a-disconnect
#3
Richard G Stefanacci
As American health care shifts from the fee-for-service, disconnected health care to value-based, holistic care, an alignment between providers and total cost of care should encourage the use of telemedicine-especially in cases where it has been shown to reduce costs and improve individual care and population.
April 2017: Managed Care
https://www.readbyqxmd.com/read/28511767/finding-the-virtue-in-virtual-care
#4
Zachary Hafner
It's going to take a lot of work. The good news is that great progress is already being made. As technology and consumer expectations continue to evolve, we can expect virtual care to play an increasingly important role in ushering in truly integrated care.
April 2017: Managed Care
https://www.readbyqxmd.com/read/28511766/medimedia-poll-of-managed-care-readers-telehealth-gets-a-warm-reception
#5
(no author information available yet)
In an online survey conducted in late February and early March, 37% of the 174 respondents rated the likelihood that telehealth will reduce health care costs as high, and 50% favored laws and regulations that would encourage its adoption.
April 2017: Managed Care
https://www.readbyqxmd.com/read/28511765/basaglar-an-insulin-follow-on-prepares-to-do-battle-with-lantus
#6
Thomas Reinke
Basaglar is coming on the scene during tumultuous times for insulin products. Manufacturers are under attack for price hikes. There are allegations of backroom rebate deals. And a class-action lawsuit has been brought on behalf of uninsured patients, charging insulin makers with setting artificially high prices.
April 2017: Managed Care
https://www.readbyqxmd.com/read/28511764/telehealth-wave-surf-s-up-for-fed-state-policymakers
#7
Richard Mark Kirkner
If millions of Americans lose Medicaid or private health insurance coverage because of the unACAing of American health care, telehealth may seem like a gimmicky sideshow rather than a good-faith effort to bring health care into the digital century.
April 2017: Managed Care
https://www.readbyqxmd.com/read/28511763/are-insurers-prior-authorization-rules-killing-opioid-addicts
#8
Joseph Burns
The results can be tragic. Patients with addictions are unlikely to wait the hours or days it takes health insurers to approve the medications they need. Insurers are changing their practices, but not without some outside pressure.
April 2017: Managed Care
https://www.readbyqxmd.com/read/28511762/a-conversation-with-henry-dephilips-md-the-doctor-in-the-teladoc-house
#9
Peter Wehrwein
The CMO of Teladoc, one of the country's largest telemedicine providers, certainly knows how to sing the praises of the industry, and handle devil's advocate kind of questions as well. Most of Teledoc's customers are commercial insurers and employers. Medicare? Not so much. Medicaid makes "perfect sense."
April 2017: Managed Care
https://www.readbyqxmd.com/read/28511761/-telemental-health-is-becoming-the-norm
#10
Timothy Kelley
One area where more research is needed is on programs that mix telemental health with traditional treatment, because in many instances a combination of the two will work better than a steady diet of either. The use of telemental health as an alternative or a backup needn't be saved for emergencies.
April 2017: Managed Care
https://www.readbyqxmd.com/read/28511760/some-thumbs-up-some-down-on-telehealth-quality-of-care
#11
Richard Mark Kirkner
Evaluating the quality of telemedicine care is about as easy as evaluating the quality of health care, period, and researchers are still ironing out the methodological kinks. That may be one reason research results are all over the place. This article involved reviewing nine such studies, and the findings are a mixed bag.
April 2017: Managed Care
https://www.readbyqxmd.com/read/28511759/telehealth-business-boom-times-but-profits-may-wait
#12
Robert Calandra
What we have here is irrational telehealth exuberance. Investors are plowing millions into startups. And even though millennials could be eager adopters, these are still early days for the industry. It may take years-and some regulatory changes-for profits to materialize.
April 2017: Managed Care
https://www.readbyqxmd.com/read/28511758/possible-employee-wariness-stifles-telehealth-s-acceptance
#13
Frank Diamond
Workers still haven't bought in. A lot hinges on this question: Do you feel comfortable getting a diagnosis or being treated for a condition by someone on a screen? Large employers especially are willing to bet that the answer is yes.
April 2017: Managed Care
https://www.readbyqxmd.com/read/28511757/telehealth-overview-the-reality-check-please
#14
Susan Ladika
The hard truth is that telehealth's future-its size, its contours-will depend a lot on what payers will be willing to pay for. Currently, commercial plans cover only a limited number of services. In addition, research suggests that there may be quality and utilization problems.
April 2017: Managed Care
https://www.readbyqxmd.com/read/28510527/the-seesaw-of-cvd-deaths-down-costs-up
#15
(no author information available yet)
Coronary heart disease deaths will decline by 30% between 2010 and 2020 because of improvement in "cardiovascular health metrics" (avoidance of smoking, more physical activity, and so on). But this less-deadly era of CVD is going to be a more costly one, with direct medical costs of CVD more than doubling by 2030 to $918 billion from $396 billion in 2012.
March 2017: Managed Care
https://www.readbyqxmd.com/read/28510526/with-repeal-and-replace-the-triple-aim-needed-more-than-ever
#16
Eneida O Roldan
The Triple Aim hit a nerve with medical directors and health care managers of all kinds. That's because it is a concise way of summarizing the disparate issues that anyone trying to manage the delivery and cost of health care must deal with.
March 2017: Managed Care
https://www.readbyqxmd.com/read/28510525/-850-per-bowel-movement-hard-to-justify-that-cost
#17
Thomas Morrow
Constipation can be a serious and painful problem, and we shouldn't dismiss other people's suffering. On the other hand there's a danger when new medications are compared against placebo rather than against over-the-counter products with a history of effectiveness.
March 2017: Managed Care
https://www.readbyqxmd.com/read/28510524/lost-in-translation-why-patient-friendly-communication-strategies-are-more-important-than-ever
#18
Barbara Antuna
Efforts to improve patient communication must become a priority. Too often, the language we use in health care is a kind of code that serves billing and other purposes. Jargon may be an efficient and precise way for insiders to communicate, but it is impossible for patients to understand.
March 2017: Managed Care
https://www.readbyqxmd.com/read/28510523/new-solutions-for-curbing-runaway-drug-costs
#19
Zachary Hafner
Long at odds, the interests of payers and providers are becoming more compatible and aligned. Both stakeholders need to collaborate to manage costs. Encouraging use of generics and biosimilars is one way they can slow down the soaring drug spend.
March 2017: Managed Care
https://www.readbyqxmd.com/read/28510522/managed-care-reader-poll-readers-believe-biosimilars-will-be-effective-against-costs
#20
(no author information available yet)
In an online survey of readers conducted in late January and early February, 20% of the 113 respondents indicated that they believed that biosimilars will be highly effective in lowering drug costs, and the reader ratings of their effectiveness skewed toward positive.
March 2017: Managed Care
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