Category: Blog

PBMs-tend-to-Dominate-State-and-Local-Markets

PBMs tend to Dominate State and Local Markets

Pharmacy benefit managers (PBMs) tend to dominate state and local markets where they provide services to commercial health insurers across the United States. That could mean patients are stuck with higher prescription drug prices, according to new research published by the American Medical Association (AMA). The Policy Research Perspective report, “Competition in Commercial PBM Markets […]
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Primary-Care-Patients-did-better-with-Telemedicine

Primary Care Patients Did Better With Telemedicine

Using telemedicine for primary care during the COVID-19 pandemic did not hurt quality of care for patients, according to a new study. Researchers examined 16 measures of primary care quality and found patients using telemedicine had outcomes as good or better than those making in-office visits, according to the study published in JAMA Network Open. […]
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HCPCS-Level-II-Code-Changes

CMS Includes HCPCS Level II Code Changes

Dozens of additions, deletions, and revisions are effective Oct. 1, 2022. The October 2022 update to the HCPCS Level II code file from the Centers for Medicare & Medicaid Services (CMS) includes more than 40 changes, and most of them are new codes. The changes are effective Oct. 1, 2022, with a few important exceptions. […]
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No-Surprises-Act-Compliance-as-a-New-Burden

No Surprises Act Compliance Debuted as a New Burden

Regulatory burden is on the rise yet again as practices struggle with prior authorizations, No Surprises Act compliance, and the Quality Payment Program, MGMA reports. Prior authorizations are still the top regulatory burden according to executives from group practices, while No Surprises Act compliance has debuted on the list this year as the second most […]
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ASC-Payment-System-Brings-New-Codes

ASC Payment System Brings New Codes and Payment Changes

The October 2022 update to the ASC Payment System brings new codes, payment indicator changes, and corrected drug payments. Fourth quarter updates to the Ambulatory Surgical Center payment system (ASC PS), effective Oct. 1, 2022, include a new device pass-through code, new HCPCS Level II codes for drugs and biologicals, and new low-cost and high-cost […]
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3 Tools to Boost Engagement with Patients

3 Tools to Boost Engagement with Patients

Adopting the right technology can help allocate or reallocate time from physicians and staff to focus on patient engagement and satisfaction. With all the pressures on physician time these days, it’s no wonder some doctors struggle to engage patients fully in their medical care, overall health and future well-being. Patient engagement efforts compete with all […]
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COVID-19-Booster-Campaign-Saves-$44B

COVID-19 Booster Campaign Saves $44B in Healthcare Spending

In addition to healthcare spending reductions, Commonwealth Fund also reports that a COVID-19 booster vaccination campaign would also prevent over 75K deaths and 745K hospitalizations. A COVID-19 boost vaccination campaign could seriously impact potential healthcare spending this fall and winter, according to a new analysis from the Commonwealth Fund. The private think tank recently examined […]
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ED-ICU-Model-Improves-Value-of-Healthcare-Delivery

ED-ICU Model Improves Value of Healthcare Delivery

The ED-ICU model has the potential to improve the value of healthcare delivery, as it has been shown to improve care quality and have little impact on emergency department costs. Total cost per emergency department (ED) patient encounter remained unchanged at an academic medical center after it implemented an emergency department-based intensive care unit (ED-ICU), […]
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