Mary Beth Nierengarten

Feature Story

05/31/2024

A push for a hybrid payment model for primary care is gaining momentum, with advocates urging the CMS to implement changes to increase funding and improve outcomes for patients.

A push for a hybrid payment...

05/31/2024

First Report Managed Care

Cover Story

Federal Oversight of Managed Care a Priority

03/01/2024

Mary Beth Nierengarten ;

In 2022, Medicare Advantage plans covered 50% of Medicare enrollees, costing the federal government $403 billion, while 81% of Medicaid enrollees received care through managed care for $254 billion. The Health and Human Services Office of...

In 2022, Medicare Advantage...

03/01/2024

First Report Managed Care

Cover Story

Navigating Work With PBMs: Negotiations, Misalignments, and Drug Costs

12/07/2023

Mary Beth Nierengarten ;

Ignoring the appropriate use of drugs is equally harmful when negotiating with PBMs, as it can and does result in the wrong drugs getting on a formulary with the obvious downstream effect on patient care, costs, and outcomes.

Ignoring the appropriate use of...

12/07/2023

First Report Managed Care

Feature

Telehealth Visits for Mental Health Offset Decreased In-Person Services During Pandemic

04/13/2023

Mary Beth Nierengarten ;

In-person mental health services declined by more than 50% after the onset of COVID in March 2020 but were offset by a 16- to 20-fold increase in telehealth services among adults covered by private payers.

In-person mental health services...

04/13/2023

First Report Managed Care

Feature

Incorporating Real-World Evidence In the Approval Processes

12/05/2022

Mary Beth Nierengarten ;

Health care stakeholders, including regulatory bodies and payers, are increasingly incorporating real-world evidence into their approval processes, prompting the need for formal guidance.

Health care stakeholders,...

12/05/2022

First Report Managed Care

Cover Story

Threat of Gun Violence Goes Beyond Individual Health

08/02/2022

Mary Beth Nierengarten ;

With the rise of gun violence across the United States, health care professionals and stakeholders across the continuum of care are calling out for recognition of gun violence as a public health issue.

With the rise of gun violence...

08/02/2022

First Report Managed Care

Feature

Countering Misinformation in Medicine

05/20/2022

Mary Beth Nierengarten ;

Medical misinformation is a growing challenge throughout health care, exacerbated by the ubiquitous use of social media that reinforces people’s tendencies to perceive and believe in things supported by other people.

Medical misinformation is a...

05/20/2022

First Report Managed Care

Feature

Preparing for Emergencies: Communication, Funding, and Innovation

04/18/2022

Mary Beth Nierengarten ;

With hospitals and health care systems already under constant pressure to be adequately prepared for natural disasters and other emergencies, refining risk assessments and a network of partners with clear communication actively in place has...

With hospitals and health care...

04/18/2022

First Report Managed Care

Cover Story

Addressing Fair Access Barriers: Payers Must Improve Transparency

02/07/2022

Mary Beth Nierengarten ;

The Institute for Clinical and Economic Review (ICER) recently outlined key conclusions from the preliminary stages of its Fair Access initiative in an attempt to create new structures to combat barriers to fair and equal access to...

The Institute for Clinical and...

02/07/2022

First Report Managed Care

Feature Story

Helping Primary Care Providers Meet the Mental Health Needs of Children

12/22/2021

Mary Beth Nierengarten ;

Mental health issues among children and adolescents have increased under the ongoing demands of a pandemic which continues to exacerbate risk factors, such as isolation and loneliness, for poor mental health.

Mental health issues among...

12/22/2021

First Report Managed Care