Multicare CFO: Decades of CMS Underpayment is Creating an Unfair Two-Tiered System
MultiCare CFO James Lee said decades of government underpayment have pushed U.S. healthcare to a…
Multicare CFO: Decades of CMS Underpayment is Creating an Unfair Two-Tiered System
MultiCare CFO James Lee said decades of government underpayment have pushed U.S. healthcare to a breaking point. He thinks the nation is headed toward a two-tier system — one for patients with commercial coverage, and another for those covered through CMS. The post Multicare CFO: Decades of CMS Underpayment is Creating an Unfair Two-Tiered System…
Elevance Health’s 3 Key Priorities for AI
Elevance Health is leveraging AI for simplifying the member experience, improving the provider experience and making sure employees have the right information at the right time. The post Elevance Health’s 3 Key Priorities for AI appeared first on MedCity News.
Lilly’s Newly Acquired Drug Shows Promise as Next-Gen Blood Cancer Med
Eli Lilly presented encouraging Phase 1 results for AJ1-11095 at the European Hematology Association (EHA) annual meeting in Stockholm. The drug, a type II JAK2 inhibitor in development for myelofibrosis, came from Lilly’s acquisition of biotech startup Ajax Therapeutics. The post Lilly’s Newly Acquired Drug Shows Promise as Next-Gen Blood Cancer Med appeared first on…
From Weight Loss to Lasting Value: The Economic Case for Structured Exercise in GLP-1 Therapy
That is the title of a recent white paper written by myself and Kristy Piccinini alongside a team from the Health and Fitness Association (Greta Wagner, Amy Bantham, Ken Griffin, Richard Beddie, Zach Weston, Cameron Saunders). Below is an excerpt: In recent years, glucagon-like-peptide-1 (GLP-1) receptor agonists have emerged as a transformative treatment option, enabling…
Ellipsis Health
Ellipsis Health has come a long way from its roots in detecting depression via vocal biomarkers. Sage, its charming voice AI agent, is now helping health plans and care management companies directly interact with patients and members, helping them with medication reminders, program recruitment, postop follow up and much more. I spoke with two of…
Don’t Leave Healthcare’s Greatest Asset Behind on the Road to Interoperability
In the push toward a more seamless, digitally enabled future, it’s important we understand exactly how this rush to interoperability may actually harm patients, instead of helping, and what we can do to make sure they keep pace. The post Don’t Leave Healthcare’s Greatest Asset Behind on the Road to Interoperability appeared first on MedCity…
Where Healthcare Data Systems Fail and How to Build Them Better
Once data starts moving across multiple systems, it becomes hard to track unless you’ve been very intentional about it from the start. The post Where Healthcare Data Systems Fail and How to Build Them Better appeared first on MedCity News.
The FDA Opened the Door For Rare Disease Patients — Here’s What It Takes to Walk Through It
The Plausible Mechanism Framework is a breakthrough. Turning it into treatments that reach families will take five things the framework doesn’t provide. The post The FDA Opened the Door For Rare Disease Patients — Here’s What It Takes to Walk Through It appeared first on MedCity News.
Spending on Medicaid State Directed Payments Before New Limits Take Effect
This issue brief analyzes Medicaid spending by state on SDPs that require prior CMS approval to better understand the use of SDPs before new limits in the reconciliation law take effect.
Forthcoming Policy Changes to Medicaid State Directed Payments
The 2025 reconciliation law reduced federal Medicaid spending by an estimated $911 billion from 2025 through 2034, some of which stems from new restrictions on Medicaid state directed payments (SDPs) for hospital and other health care services. This issue brief describes SDPs and forthcoming policy changes stemming from the 2025 reconciliation law and the proposed…
