Faced with potential federal spending cuts that threaten health coverage and falling childhood vaccination rates, Monica Soni, the chief medical officer of Covered California, has a lot on her plate — and on her mind. California’s Affordable Care Act health insurance exchange covers nearly 2 million residents and 89% of them receive federal subsidies that…
After years working with CHCs, John Torontow, M.D., M.Ph., sees value-based care as more than a payment strategy. He argues it is an opportunity to make the health centers’ often-invisible work measurable, recognized and financially sustainable.
As reported by EndPoints: President Donald Trump on Tuesday signed an executive order offering support for a change to the IRA’s “pill penalty,” one of the industry’s long-standing policy priorities that could affect billions of dollars in drug costs under Medicare. The executive order on drug pricing contains a grab-bag of policy proposals, some of…
Providers need a revenue cycle management platform that is more affordable and accurate, said Jeremy Dekinsky, CEO of Smarter Technologies, during MedCity News’ INVEST conference. New Mountain Capital formed Smarter Technologies this week by combining three separate platforms it had already acquired. The post How a New PE-Backed RCM Company Plans to Fix the ‘Transactional…
Effective contract management for healthcare organizations is pivotal in this complex and highly regulated world. Healthcare organizations, whether large hospitals, clinics, or individual practitioners, contract with various entities, including vendors, insurance providers, and regulatory bodies. These contracts govern everything from purchasing medical supplies to services reimbursement, making healthcare contract management a critical aspect of running…
That is the title of my paper out today in the Journal of Comparative Effectiveness Research written with co-authors Adam Kittai, Dipen Patel, Nadine Zawadzki, Vikram Shetty, Yazan Barqawi, and Joanna Rhodes. The abstract is below. Aim: To estimate cost savings associated with covalent Bruton’s tyrosine kinase inhibitor (cBTKi) choice in patients with treatment-naive (TN) and…
Catastrophic healthcare expenditures (CHE) are highly problematic for families are are unequally distributed throughout society. However, how can we quantify the incidence, intensity and inequality of CHE in a society? A paper by Ogwang and Mwabu (2025) provide one methodology by using the Watts poverty measure and adapting it to measure CHE. We first describe…
The Trump administration aims to change the Medicare Drug Price Negotiation Program in a way that would delay when certain drugs can be selected for negotiation. The post Trump’s Executive Order on Prescription Drug Costs Delivers a Win for Pharma Companies appeared first on MedCity News.
[Sponsored] Balancing recovery with professional obligations can feel overwhelming. The post Personalized Rehab Solution: Supporting Patients With Work Responsibilities appeared first on MedCity News.
The tools exist today to significantly reduce PA’s burden on our healthcare system, we just need to mobilize and implement them. The post A Four-Part Roadmap for Responsible Prior Authorization appeared first on MedCity News.