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Alabama’s Integrated Care Network Program

In this document released on March 15, 2018, the Alabama Medicaid Agency presented its concept for an Integrated Care Network (ICN) to manage LTSS. The ICN will provide enhanced case management, education, and outreach services for people receiving LTSS. The […]

Navigating The Changing Relationships Between Health Plans & Provider Organizations

Not too long ago, the relationship between health plans and provider organizations was straightforward. Health plans purchased services on behalf of consumers—if they were preauthorized—and provider organizations provided those services in commodity-like network arrangements. Over the past decade, that relationship […]

Why Z-Codes Matter For Provider Organizations

Over the past couple of months articles surrounding coding and the social determinants of health have been popping up in the news—see AMA & UnitedHealthcare Partner To Propose New ICD-10 Codes To Identify & Address Social Determinants Of Health, UnitedHealthcare […]

Colorado Opioid Deaths Down 6% After Marijuana Legalization

After Colorado legalized the sale and use of recreational marijuana in 2014, the number of opioid-related deaths declined by more than 6% between 2014 and 2015. Before the state legalized recreational use, opioid-related deaths had been trending up, from about […]

Will Health Plan Backward Integration ‘Remake’ Specialty Care?

“Backward integration.” This is a business strategy concept – “when a company expands its role to fulfill tasks completed by organizations in its supply chain.” In health care, we’re seeing backward integration by health plans, particularly into primary care. Most […]