Funding is Key for Patient Experience
Technology has been a crucial component of the medical industry for many years, and this has only increased since the onset of the pandemic. However, it is becoming increasingly clear that the $6.7 billion in funding for the digital health sector is a driving force...
CMS Tabling Geographic Direct Contracting Model: What Does It Mean?
Medicare’s existing Geographic Direct Contracting model has been controversial legislation for years. This regulation intends to test the feasibility of basing pricing models on regional trends. The Centers for Medicare and Medicaid Services (CMS) aimed for this...
CMS Pressure to Cover Diabetes Prevention Program
The Centers for Medicare and Medicaid Services (CMS) may implement long-awaited changes to the Medicare Diabetes Prevention Program (MDPP) initially established by the National Institute of Health in 2018. The program has been successful among many middle-aged and...
Medicare’s Direct Contracting Changes to Help Expand Primary Care Provider Networks
In the case of health care services for subscribers, more options is usually not a bad thing unless providers are sacrificing quality care. Medicare’s most recent initiative, put into place January 1, 2021, focuses on modifying Direct Contracting models to emphasize...
Continually Shrinking Profits for Health Care Providers Throughout the Pandemic
Despite ever-growing hospitalization rates associated with COVID, health care providers and institutions are struggling to profit in today’s economy. Many hospitals and nursing facilities are seeing an influx of inpatient admissions due to respiratory illnesses and...
The No Surprises Act: What Does it Mean for Insurers?
Due to legislation passed on December 22, 2020 as part of the COVID relief plan, patients who receive emergency medical services will have peace-of-mind due to fewer unexpected health care costs. As part of the “No Surprises Act,” (also known as the Act) patients will...
California Expanding Their Mental Health Parity Act
Starting in January 2021, California residents with substance use disorders and mental health concerns will now have greater access to coverage. The amendment to SB-855 expands on legislation from September 2020 that requires state-based insurers to follow...
CMS Passes Law Mandating Improved Hospital Cost Transparency
Spurred by a recent analysis that found many top hospitals provided inconsistent cost-related information, hospitals will now be adopting new, clearer pricing materials. The Centers for Medicare and Medicaid Services (CMS) are now requiring all hospitals to clearly...
The Impact of Managed Medicaid on Insurance Networks: Good or Bad?
In January 2020, the District of Columbia issued an RFP for the D.C. Healthy Families Program, the District of Columbia Healthcare Alliance Program, and the Immigrant Children’s Program. These small-scale RFPs -- which are expected to cover just under 200,000...
COVID Exacerbates Network Inadequacy for Children’s Behavioral Health Providers
The large-scale disruption that is occurring in the lives of children will likely last through 2021. Consequently, there is a great deal of professional concern over the short-term and long-term impact of isolation in children who are being kept from a formative...