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MOM’S HEALTH: In celebration of National Women’s Health Week, through Saturday, Buckeye Health Plan is spotlighting the need for moms to put their own health first, by staying up-to-date on important health screenings and preventative care appointments. Many preventive screenings can be completed or prescribed at an annual well visit. These visits are just as important in adulthood as they are during your childhood.
According to the Centers for Disease Control and Prevention (CDC), six in 10 adults in the U.S. have chronic health conditions, like heart disease, cancer, lung disease, diabetes, etc. Four in 10 adults have two or more. In fact, heart disease is the leading cause of death for women in the U.S.
Mississippi started investigating its largest Medicaid contractor 2 years ago djournal.com - get the latest breaking news, showbiz & celebrity photos, sport news & rumours, viral videos and top stories from djournal.com Daily Mail and Mail on Sunday newspapers.
Conflicting Corporate Claims At The Heart Of Ohio s Blockbuster Medicaid Suit Patch 1 hr ago
Two mega-corporations appear to be claiming they did the same work for Medicaid Ohio’s $24 billion-a-year program that provides health care to the poorest 25% of state residents.
Since the companies received at least $53 million for the work in 2017 alone, the conflicting claims could be a big problem one with potential implications in the many states where the companies do Medicaid business.
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Ohio Attorney General Dave Yost last month filed suit against Centene, the largest Medicaid contractor in the United States, accusing it of charging the state for services it didn’t perform, among other things.
Modern Healthcare Illustration / Getty Images
Ohio officials expect that consolidating the seven private pharmacy benefit managers that run its Medicaid managed-care system into a single, state-regulated PBM will save more than $240 million every year. The change will go in effect starting in early 2022.
Officials will administer PBM services through Gainwell Technologies, a state-regulated PBM that will replace the seven PBMs currently operating in the managed-care system. A pharmacy pricing and audit consultant will help state officials make decisions with regard to in-network providers, pharmacy reimbursement and more.
Ohio Department of Medicaid Director Maureen Corcoran declined to name the consultant working with Ohio.
Novant Health adds chief payor performance officer
Novant Health adds chief payor performance officer
Erik Helms
Novant Health hired a chief payor performance officer, which experts say seems to be a novel role among health system C-suites.
Erik Helms, who was chief performance officer for Buckeye Health Plan, will oversee Novant s payer relationships and pricing strategy. Executive compensation and governance experts said they hadn t seen that specific positions carved out by health systems.
Health system executive roles ebb and flow year to year. Technology, population health, reimbursement and telehealth have been relatively new additions to the health system C-suite, but some will naturally rise or wane.