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The pursuit of value with risk models

Matt Siegel, Verisk Health

The proliferation and variety of accountable care designs in commercial insurance, Medicare Advantage and managed Medicaid highlight the need predict the appropriate cost of care, ensure access to needed services and raise quality. But how can value be measured?

Will stricter controls on painkillers curb abuse and addiction?

G Caleb Alexander, Kevin Fain, Matthew Daubresse

Americans consume a staggering amount of the opioid painkiller hydrocodone, about 99 percent of the world's supply. In October, after 10 years of debate the Drug Enforcement Agency (DEA) reclassified medications like Vicodin, and products that combine hydrocodone with other drugs, as Schedule II controlled substances.

Reforming Medicare: What does the public want?

Marge Ginsburg, Joseph Antos, Kavita Patel

Is Medicare adequately meeting the needs of seniors, or are there ways that its core attributes could be improved?  Few efforts have tried to understand how the public would change Medicare's basic design.

One certainty this enrollment season is chaos

Robert Laszewski

The Obama Administration will be telling us the website, call centers, and carriers are very busy with people all excited about the Affordable Care Act. They just won't be defining excitement.

What insurers can address in HIX experiences

Dan Brostek, Merkle

As we approach the second open enrollment for insurance exchanges, one thing is clear: purchasing individual health insurance will continue to be a complicated experience that involves multiple touch points and channels with payers and federal or state marketplaces. 

Obamacare debate isn't over

Robert Laszewski

We didn't see a Republican tide on election night. We saw a Republican tsunami.

Bridging the gap in health plan shopping

Mitch Rothschild, Vitals

Open enrollment is right around the corner, but where are the shoppers?

Harvard HMO debate raises provider choice, value dilemma

Paul Levy

What happens when the WGU, "World's Greatest University," as Harvard is affectionately known around Boston, decides to redesign its faculty and employee health benefits plan?

The good, bad and ugly in Medicare Advantage

John Gorman, Gorman Health Group

In the last few weeks there's been good, bad and ugly news for Medicare Advantage (MA) plans. On one hand, the program has never been stronger and quality metrics are surging in the right direction; on the other, the industry is sucking it up on following the rules of its biggest customer, the Centers for Medicare & Medicaid Services.

Still using horses and buggies

Paul Levy

I recently had to reschedule a routine exam with my hospital-based primary care doctor and so decided to use the supposed rescheduling functionality on the patient portal to carry out this task. 

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