What do Centene, CVS Health-Aetna and Humana all have in common? (Trying really hard not to start off with a “three health plans walk into a bar” joke…). Well, if you were at the 41st annual J.P. Morgan Healthcare Conference,...more
CMI, CMMI, and Changing the Consumer Experience in the U.S. and China -
Case Mix Index: Sitting in multiple hospital, payor and physician organization presentations at the J.P. Morgan healthcare conference this year, it is...more
1/17/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
China ,
CMMI ,
Health Care Providers ,
Health Insurance ,
Healthcare Facilities ,
Hospitals ,
Life Sciences ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Outpatient Services ,
Universities ,
Value-Based Care
The Big Cost; Cancer is the Answer; and SDOH Evolves -
The Big Cost: You’re okay today, and then tomorrow you’re not. Life has changed and there’s a new reality. Whether it’s an acute event – an accident, a heart attack, a...more
1/16/2020
/ Affordable Care Act ,
Affordable Housing ,
Cancer ,
Genetic Markers ,
Health Care Providers ,
Health Insurance ,
Hospitals ,
Innovation ,
Medicare ,
Outpatient Services ,
Pharmaceutical Industry ,
Physicians ,
Prescription Drugs ,
Professional Conferences ,
Technology ,
Value-Based Care
If I printed a tee shirt for the 2020 J.P. Morgan Healthcare Conference, what would it say? In past years, it would have been “Big Data,” Analytics, Artificial Intelligence, ACA, Risk, Medicare Advantage or Quality. This...more
1/15/2020
/ Data Management ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Costs ,
Hospitals ,
JPMorgan Chase ,
Medicaid ,
Medicare ,
Patients ,
Pharmaceutical Industry ,
Pharmacies ,
Physicians ,
Professional Conferences ,
Value-Based Care
Please Don’t Poke the Baby – Sharing a best practice and talking about taking a local hospital learning and turning it into a systemwide approach, Mark Harrison of Intermountain Healthcare shared the fact that taking fewer...more
1/9/2019
/ Affordable Care Act ,
Cancer ,
Drug Pricing ,
Food Safety ,
Health Care Providers ,
Health Insurance ,
Hospitals ,
Medicaid ,
Partnerships ,
Physicians ,
Public Health ,
Public Safety
San Francisco (January 11, 2018) – The final day of the 2018 JP Morgan Healthcare Conference gave us food for thought about the topic of healthcare navigation, as well as updates on the home health sector. Post-acute has...more
1/15/2018
/ Centers for Medicare & Medicaid Services (CMS) ,
Genesis HealthCare ,
Health Care Providers ,
Health Insurance ,
Healthcare Costs ,
Healthcare Workers ,
Home Health Care ,
Hospitals ,
Humana ,
Joint Venture ,
JPMorgan Chase ,
Medicare ,
Mergers ,
Patients ,
Professional Conferences ,
Self-Insured Health Plans ,
Skilled Nursing Facility ,
Telehealth
The ancient Chinese curse – “May you live in interesting times” – certainly springs to mind these days. What does the election of Donald Trump mean for the healthcare industry, the Affordable Care Act and current healthcare...more
11/10/2016
/ ACOs ,
Affordable Care Act ,
Children's Health Insurance Program (CHIP) ,
Health Insurance ,
Health Insurance Exchanges ,
Healthcare Costs ,
Hospital Mergers ,
Hospitals ,
Industry Consolidation ,
Lobbying ,
Medicaid ,
Medicaid Expansion ,
Medicare ,
Medicare Access and CHIP Reauthorization (MACRA) ,
Physicians ,
Prescription Drug Coverage ,
Presidential Elections ,
Repeal ,
State Taxes ,
Subsidies ,
Telemedicine ,
Trump Administration
A new study by Stanford University researchers finds that Medicare Advantage plans pay lower prices than traditional fee-for-service (FFS) Medicare for most types of hospital admissions. According to the study—published...more
Maryland’s Evergreen Health Cooperative has filed for an injunction against the federal government to halt payment by the Consumer Operated and Oriented Plan (co-op) of the $22 million it owes to CareFirst BlueCross...more
Every year in May, the health ministers from all 194 World Health Organization (WHO) Member States meet at the WHO headquarters in Geneva to attend the World Health Assembly (WHA). As the decision-making body of WHO, the WHA...more
In mid-December, President Obama signed into law a $1.1 trillion spending bill known as the “Consolidated and Further Continuing Appropriations Act, 2015” or “Cromnibus.”[1] This post explores provisions that relate to the...more
Network adequacy—a health plan’s ability to provide timely access to a sufficient number in-network providers—has become a matter of increased scrutiny during these early years of ACA implementation; Many consumer and...more
Anthem Blue Cross and seven competing hospital systems in Southern California are joining forces to establish a new health plan offering, Vivity.[1] Operating with a combined 14 hospitals and approximately 6,000 physicians,...more
Will insurance expansion and industry consolidation result in higher healthcare costs, at least in the short term, and further stress the economy and the healthcare industry? That highly political question is being asked now...more