Preston Yutzey, MBA, SHRM-CP

💡New #Avalere Study 💡Do #340B contract pharmacies serve patients in rural areas? Do 340B hospitals contract with chain or independent pharmacies? Our team crosswalked a couple of data sets to get some snapshots of trends in contract pharmacy use in 340B to inform the ongoing debate in Congress. Reach out to learn how we can help you with policy design and analytics. #drugpricing #drugs #lifesciences

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If over 50% of the births in Mississippi are financed by #Medicaid and over 75% of Medicaid recipients are in #managedcare, it makes sense to review contract requirements for managed care organizations. The organizations play a fundamental role in assuring timely, equitable, quality care and improving maternal health outcomes. In this article, Milbank Quarterly offers a close review of managed care contracts and shows that the absence of a national set of #maternalhealth standards has caused challenges in setting expectations for managed care performance. Table 1 in the study offers a summary of contractual findings, including in #Mississippi. Twenty-five contracts require perinatal risk assessments by the MCO or a provider, but most of these contracts do not require risk assessments throughout the full continuum of care. Only two states require risk assessment in the postpartum period (California and Louisiana). Yet nearly half of pregnancy-related deaths occur one week to one year after delivery, when most individuals would have left the hospital. All MCOs are required to include obstetrician gynecologists (OB-GYNs) in network, and seven states explicitly require high-risk obstetrician specialists (maternal–fetal medicine). Mississippi is not one of those states. Full article: https://lnkd.in/gF-45tJ2

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We're only TWO weeks away from the #ACDIS CDI Week State of the Industry webinar! Our CEO and Co-Founder Michael Gao will join ACDIS and other CDI experts to discuss the findings via a webinar on Sept. 19 from 12-1:30 p.m. CDT. Plus, you get 1.5 ACDIS CEUs for attending. https://lnkd.in/efnji4vY ACDIS surveyed more than 800 #CDI professionals about a wide range of topics. For example: ▪️ 70% of CDI professionals say they have a 91-100% physician query response rate within their facility’s required timeframe ▪️ 64% of CDI programs are involved with some sort of denials management ▪️ 47% report reviewing pediatric cases in either the inpatient or outpatient setting

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A report by the Office of the National Coordinator for Health Information Technology (ONC) shows progress in hospital electronic health information exchange. 43% of hospitals now routinely engage in all four domains of interoperability (send, receive, find, and integrate), up from 28% in 2018. While hospitals have made significant progress in interoperable data sharing, further work is necessary to achieve nationwide, routine exchange across the healthcare continuum. Emphasizing the importance of routine data exchange, addressing disparities, and enhancing data sharing will ensure all patients benefit from better care coordination and seamless decision-making. https://lnkd.in/gJJ2hnb5 I #Interoperability #EHR #HealthInformationExchange #HealthData #ONC HIT Consultant Media

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📅 Webinar (5/20, 1:00 pm ET) | HHS’ Office of Civil Rights has published a final rule with a significant requirement for any covered entities, including health care providers and payers, that use algorithms potentially impacting patient care or access. Is your organization prepared? Join Epstein Becker Green's Lynn Shapiro Snyder and Bradley Merrill Thompson, RAC, as they explore how the rule goes beyond simply prohibiting algorithmic discrimination and requires due diligence by health care providers and payers in the form of a compliance program. Here’s what you’ll learn: ▶ Key risk areas for algorithmic discrimination ▶ Understanding the scope of the new rule, specifically with regard to what types of algorithms are subject to it ▶ The requirement in the new rule that covered entities, including health care providers and payers, be vigilant in looking for possible discrimination ▶ Risk mitigation steps targeting algorithmic bias that organizations must adopt as a part of a compliance program to avoid HHS enforcement Don’t miss out—register now: https://bit.ly/3wqR6Vw #ArtificialIntelligence #Algorithms #HealthCare

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