• 12.19.17

    Leveraging Medicaid to Strengthen Coverage

    States continue to develop strategies to strengthen coverage across the individual market and Medicaid. In recent months, we have seen several proposals at both the federal and state levels that would leverage state Medicaid programs as a key component of coverage stability and affordability ...

  • 11.15.17

    Medicaid Changes and Implications for People Living With HIV

    Traditionally, Medicaid eligibility was limited to low-income children, parents, pregnant women, the elderly and the disabled. The Affordable Care Act (ACA) gave states the option to cover nondisabled, low-income adults, and 31 states, plus D.C., have now expanded Medicaid coverage.

  • 11.14.17

    Discover the Megatrends Remapping the Pharmaceutical Market

    From the shift to new payment models to the explosion of mHealth to the creation of personalized therapies, powerful trends and disruptive innovations are converging to reshape the healthcare market. Patients, payers and providers are all facing transformational forces that are reinventing ...

  • 10.25.17

    How Can You Attract Patients Beyond Your Local Market?

    International patients seeking advanced medical treatment spent more than $3.5 billion in the United States in 2015, increasing more than 25% since 2010. 1 Each year, 300,000 international patients visit this country for quality medical care. 2 Domestic medical travel is also on the rise. ...

  • 09.25.17

    What Are the Implications of the New Graham-Cassidy Proposal for Coverage, Costs and State Budgets?

    On Sept. 13, 2017, Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA)—along with Senators Dean Heller (R-NV) and Ron Johnson (R-WI) and former Senator Rick Santorum (R-PA)—released a new proposal to “repeal and replace” the Affordable Care Act. The new proposal is an ...

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    09.11.17

    As Enforcement Tightens, How Can You Avoid FCA Actions?

    In fiscal year (FY) 2016, the Department of Justice (DOJ) recovered $2.5 billion from healthcare fraud cases, marking the seventh consecutive year that healthcare civil fraud recoveries exceeded $2 billion. Between January 2009 and the end of FY 2016, the DOJ recovered $19.3 billion in healthcare ...

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    07.19.17

    Building Successful PAC Preferred Provider Networks

    From new reimbursement models to an aging population to an increased focus on holistic treatment, key trends are converging to drive the surging growth in post-acute care (PAC) preferred provider networks. Hospitals and health systems are seeking to integrate with PAC by creating networks of ...

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    06.06.17

    How to Avoid HIPAA Traps When Using New Technologies

    New technologies are transforming healthcare. According to a HIMSS Mobile Technology Survey of healthcare provider employees, about 90% say they are using mobile devices to engage patients in their healthcare—and 36% believe app-enabled patient portals are the most effective patient ...

  • 04.27.17

    How Will Healthcare M&A Change Under the Trump Administration?

    The healthcare M&A market continues to be among the most active sectors. In 2016, there were 939 healthcare industry deals in the U.S. with an aggregate value of approximately $71.7 billion. How will policies and goals of the new administration likely impact healthcare M&A trends? How ...

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    03.08.17

    What Are the Potential Implications of Capping Federal Medicaid Funding?

    Key leaders in Congress and high-ranking members of the Trump Administration are proposing major changes to Medicaid financing through the adoption of a block grant or per capita cap. (The proposed American Health Care Act would convert Medicaid financing from the current guaranteed matching rate ...

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