Section 1115 Medicaid demonstration waivers offer states an avenue to test new approaches in Medicaid that differ from what is required by federal statute, so long as the approach is likely to “promote the objectives of the Medicaid program.” As with broader Medicaid policy, the future landscape of Section 1115 waivers depends on the outcome…
Millions of healthcare claims are denied annually, costing providers billions in lost revenue and expensive appeals. A 2024 survey shows that around 15% of all claims submitted to private payers, Medicare Advantage and Medicaid managed care plans are initially denied. Since most involve charges of $14,000 and above, the stakes are worryingly high. Frustratingly, more…
In a video posted to Reddit this summer, Lucie Rosenthal’s face starts focused and uncertain, looking intently into the camera, before it happens. She releases a succinct, croak-like belch. Then, it’s wide-eyed surprise, followed by rollicking laughter. “I got it!” the Denver resident says after what was her second burp ever. “It’s really rocking my…
CHARLOTTE, N.C. — During the heat dome that blanketed much of the Southeast in June, Stacey Freeman used window units to cool her poorly insulated mobile home in Fayetteville, North Carolina. Over the winter, the 44-year-old mom relied on space heaters. In both instances, her energy bills reached hundreds of dollars a month. “Sometimes I…
By SAMANTHA MCCLENAHAN Every breakthrough in cancer treatment brings hope, but it also comes with a staggering price, raising a critical question: how do we balance groundbreaking advances with the financial reality that could limit access for many patients? Developing new cancer medications involves extensive research, clinical trials, and regulatory approvals; a lengthy process that…
A paper by Campbell et al. (2024) provides some guidance. The authors developed a series of recommendations based on literature review, expert interviews and an expert workshop in order to support consistent and transparent evaluation and use of validated family spillover effects in health technology assessments (HTA) and cost-effectiveness analyses (CEA). The expert panel consisted…
Dr. Sophia Yen is the Chief Medical Officer (and Founder) of Pandia Health. She is about as expert as it comes on the topics contraception, emergency contraception, medication abortion, menopause and lots more. Her PR peeps asked if I’d interview her about Pandia Health, which is a fantastic online clinic & pharmacy for women at…
Omada Health is a respected health tech company but what do customers see it? A flesh and blood and an AI analysis follows. The post What Do Consumers and AI Think Of Omada Health? appeared first on MedCity News.
Cyril Philip, vice president of digital health ventures with Bon Secours Mercy Health and digital ventures lead for Accrete Health Partners, is taking part in a panel discussion at INVEST Digital Health in Dallas on September 18. In response to emailed questions, he addressed some of these challenges. The post What Challenges Do Implementing New…
Positive preliminary results for Eli Lilly’s efsitora alfa continue to build the case for this once-weekly insulin in type 2 diabetes patients. Lilly is trying to catch up to Novo Nordisk’s once weekly insulin icodec, which is commercially available in several markets around the world but is not yet approved by the FDA. The post…