Prepare for Medicaid Access Changes: What Your Health Plans Need to Know Now
Network inadequacy can create a big headache for health plans, so payers should give special attention to any legislative changes (either proposed or finalized) to these policies. One potential change is related to Medicaid and managed care access standards. Since the...
Do You Value Predictable ROI From Your Provider Network?
TOG Launches Medical Economics Division Optimizing Payer Profit Margins TOG is now the only health care provider network builder with a medical economics division that supports the full network operations life cycle. The division was added to help payers make sound...
Record-Breaking ACA Enrollment: What It Means for Your Health Plan
Estimated Read Time: 3 Minutes The Affordable Care Act has hit a historic milestone! Over 20 million Americans are now enrolled in individual marketplace plans – nearly 6% of the population. In 2023, there were 16.3 million individuals enrolled in these plans, which...
Infectious Disease Cases are Rising: How Can Your Health Care Provider Network Act as a Buffer?
Estimated Read Time: 5 Minutes Learn how your health care provider network can: Identify community hot spots & engage vulnerable populations. Craft engaging educational content for optimal reach & impact. Boost patient engagement & safety through testing...
Preventive Vision Care Can Lead to Better Brain Health Outcomes
A new study from the Journal of American Medicine: Ophthalmology shows that all types of visual impairments are associated with a higher risk of dementia. Between 12 and 32% of individuals with visual impairments are also diagnosed with dementia. This variation in the...
Managing an Increase in Pharmaceutical Spending on Specialty Drugs
A recent report by Vizient expects that hospitals will see a nearly 3.5% increase in pharmaceutical spending next year. Much of this increase can be attributed to medications for diabetes and neurological conditions, along with specialty drugs such as those for cancer...
Medicare Begins Historic Price Negotiations for Popular Medications
For the first time in its nearly 60-year history, Medicare began negotiating prices for ten widely prescribed drugs. Negotiations began in September 2023, and are a direct response to the recently passed Inflation Reduction Act. The proceedings, which will run from...
Insurer Considerations Becoming Crucial Amid Wearable Technology Growth
Wearable technology has become a staple in many American households over the past few years. Fitness trackers are especially popular among individuals looking to monitor their basic vital signs and increase their physical activity. Wearable technology has even become...
Optimize Your Health Plan’s Provider Network With Our Comprehensive Guide
A high-performing provider network is essential for a successful health plan. It can help you attract and retain members, improve quality outcomes, reduce costs, and bolster financial performance. However, moving to a more productive provider network can be a complex...
How Insurers Can Minimize Effects of Unexpected Medication Shortages
Many companies (including but not limited to health care organizations) experienced the negative effects of supply chain shortages during the COVID-19 pandemic. However, there are other reasons for such supply issues. The most recent shortage has impacted many...