Managed Care & Payer Strategy
Expert articles and analysis related to managed care & payer strategy.
AI Summary â Last 7 Days
Over the past week, CMS under the Trump administration advanced voluntary, technology-enabled value-based care with the announcement of 150 participants for the new Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) model, which aims to tie provider payments for chronic disease management to measurable results and accelerate adoption of digital health solutions (Healthcare Finance, [Weekly Voice](https://news.google.com/rss/articles/CBMi0AFBVV95cUxPMVZ3aDl3Z0NhY0JZY1M0amhwQkh1aGhCX3ZSTWFvRTNNQmtNS0pYUWdFTUZES1dBclJPcFlPcjFRaURYbVFiLWgxazMteTJ1VWdsclMtTjR2UVEyUS1za0xCOXZBaTdCMktxZDR3dnJWbm5WT0x2SF9qdmtnZUM1a0dNOVF2cERtbTlXQ1JlZk9TbHFWdF8zZ0xETnI5WEk2aXZRQUVhODNESFV6RllvT2VWaTVBYl95dER6YWI1TDFJN2M2Q3pFekJrTXUyZUdq?oc
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The LI Daily: Prior Authorization: I Killed It Once. They Brought It Back. Now the Data Shows Why.
Prior Authorization: I Killed It Once. They Brought It Back. Now the Data Shows Why. A former health plan CMO followed the money â and the numbers are worse than the industry wants you to know. Archel...
More insurance claims denials are being overturned upon appeal, study finds
Study authors, who reviewed data from New York, said rising rates of overturned claims suggest that insurersâ claims review processes might not be working as intended, and policymakers should consider...
The Operational Drag of Prior Authorizations and the Moral Hazard Impact on Patients
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Care delays and denials grow across 6 states using WISeR Model, lawmaker says
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Sen. Amy Klobuchar discusses need to address prior authorization, workforce, telehealth in rural areas
Sen. Amy Klobuchar discusses need to address prior authorization, workforce, telehealth in rural areas  American Hospital Association
UnitedHealthcare Expands Rural Healthcare Initiatives, Reduces Prior Auth Requirements
UnitedHealthcare Expands Rural Healthcare Initiatives, Reduces Prior Auth Requirements  MedCity News
Treatment Delays, Denials More Common in Prescriptions Initially Rejected
Listen: With Little Federal Regulation, States Are Left To Shape the Rules on AI in Health Care
As artificial intelligence embeds itself into health care, some physicians and patient advocates worry it could be used by insurance companies to refuse payment for care. Maryland passed one law banni...
Data highlights gaps in finding in-network mental health coverage
Data highlights gaps in finding in-network mental health coverage  American Hospital Association