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ºìÁì½í¹Ï±¨ Insights: Your source for healthcare news, ideas and analysis.

ºìÁì½í¹Ï±¨ Insights – including our new podcast – puts the vast depth of ºìÁì½í¹Ï±¨â€™s expertise at your fingertips, helping you stay informed about the latest healthcare trends and topics. Below, you can easily search based on your topic of interest to find useful information from our podcast, blogs, webinars, case studies, reports and more.

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147 Results found.

Brief & Report

Report looks at Managed Care Organizations’ outreach efforts

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The Commonwealth Fund

As state Medicaid programs are increasingly shifting beneficiaries into managed care organizations (MCOs), some MCOs are expanding their traditional role to better meet the needs of their vulnerable members and communities.

In a new Commonwealth Fund report, ºìÁì½í¹Ï±¨ Managing Principal Sharon Silow-Carroll and Consultant Diana Rodin, report on the efforts of four managed care organizations (MCOs) that are forging community partnerships to meet the needs of vulnerable Medicaid patients and others in their communities.

They developed four case studies:

These case studies describe the “how” and the “why” when it comes to MCOs addressing barriers and changing the way care is delivered, including internal and state policy drivers, leveraging partnerships and key take-aways.

 

Brief & Report

New report details state dual integration efforts

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In the fall of 2012, ºìÁì½í¹Ï±¨ Senior Consultant Jenna Walls and colleagues from the AARP Public Policy Institute, and the (NASUAD) surveyed all 50 states and the District of Columbia to develop a comprehensive picture of emerging dual integration initiatives for older adults and adults with physical disabilities.

The research shows that two-thirds of all states will integrate Medicaid and Medicare services for dual eligibles over the next two years, most with statewide initiatives designed to target all full-benefit duals and span most types of long-term care services and supports. In addition, the report discovered that most states are turning to risk-based managed care models to deliver these integrated services to duals.

 

Brief & Report

Hospital Charges and Reimbursement for Drugs: 2019 Update Analysis of Markups Relative to Acquisition Cost

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Analyses of prescription drug spending trends may not always include the role various parts of the pharmaceutical supply chain play in those trends. We estimate, based on publicly available data, how much hospitals paid, on average, to acquire a drug from its manufacturer. We then calculate the amount by which hospital charges and commercial insurers’ payment to hospitals for those drugs exceeded their acquisition cost. The tables that follow analyze hospital mark-ups and margins by site of service for 20 individual drugs for commercial payers.