Key Considerations for Health Care Provider Telehealth Strategies

The last time I wrote about telehealth, I noted that there remained substantial room for growth.  While that remains the case, telehealth has been rapidly increasing in popularity over the last several years as more technology options have become available, payers increasingly reimburse for it, and state regulations have been modernized.  Increasingly, health care organizations … Read more

Assessing the Financial Performance of Medicaid Managed Care Organizations in Texas

Although the Texas Medicaid managed care market is highly concentrated, the managed care organizations operate at low margins and most of the funds paid to them is paid out to health care providers for medically necessary covered services. Health care services covered by the Texas Medicaid program are primarily organized and paid for through managed … Read more

Estimating the Cost of the Opioid Epidemic to State and Local Governments

Numerous state and local governments are suing the makers and distributors of prescription opioids seeking to recover damages for alleged improper marketing and distribution of various prescription opioid medications.  In December of 2017, the U.S. Judicial Panel on Multidistrict Litigation transferred 46 of these cases to the Northern District of Ohio for coordinated and consolidated … Read more

Developing a Strategy for Addressing the Social Determinants of Health

The social determinants of health play a larger role in determining overall health than does clinical care.  Health care organizations, particularly those serving low-income or otherwise vulnerable populations have a significant opportunity to improve the health of their patients and members, and their own bottom lines, by developing and implementing strategies for addressing the social … Read more

The Potential Role of Information Technology in Fighting the Opioid Epidemic: Opportunities and Limitations

While the number of deaths annually due to drug overdoses in the United States has been climbing steadily since 2000, over the last several years the rate of increase has accelerated.  The main factor responsible for this rise has been the increasing use and abuse of prescription and non-prescription opioids, which has reached such a … Read more

A Tale of Two Storms – Transformation of the e-Health Ecosystem between Katrina and Harvey

The current use of e-health tools and services within the health care industry – including the adoption of electronic health records (EHRs) by physician and hospitals, the development of electronic health information exchange (HIE) networks, and the maturation of the telemedicine market – clearly contributed positively to the quality of, and access to health care … Read more

A Modest Proposal… wherein I describe my own recipe for the ‘repeal and replace’ of Obamacare

As the Obamacare debate continues, Congress will have a choice of whether to maintain the status quo, or to pursue a minimalist legislative fix, comprehensive reform, or something in between.  I propose something in between – a moderate and relatively light package of reforms to the individual health insurance market including some changes that are … Read more

Select Empirical Realities of the Individual Health Insurance Market as Structured by the Affordable Care Act

With the recent filing of the American Health Care Act (AHCA) to ‘repeal and replace’ Obamacare (that I’ve discussed previously on this blog), it is useful to ensure that everyone has a clear understanding of the scale of the potential impact. While the AHCA (and the ACA, even more so) did lots of different things, … Read more

The Bill to ‘Repeal and Replace’ Obamacare May Break the Individual Health Insurance Market

Congressional Republicans have unveiled their bill to ‘repeal and replace’ Obamacare.  The bill includes provisions that would adversely affect older Americans and place financial strains on states and hospitals, and may even break the individual health insurance market.  On the plus side, it appears to have little political support, so may be ‘dead on arrival.’ … Read more