Richard G Stefanacci, DO, MGH, MBA, AGSF, CMD—Column Editor

Clinical Pathways GPS

The Future of Medicare…Medicare Managed Care

03/16/2022

Richard G. Stefanacci , DO, MGH, MBA, AGSF, CMD;

Richard G Stefanacci, DO, MGH, MBA, explains why it is highly likely that Medicare managed care will represent over half of the Medicare market in the next year and, therefore, become a leader not only for Medicare care but also a guide for...

Richard G Stefanacci, DO, MGH,...

03/16/2022

Journal of Clinical Pathways

Clinical Pathways GPS

Digital Health Placement in Clinical Pathways

12/16/2020

Richard G. Stefanacci , DO, MGH, MBA, AGSF, CMD;

Martin Culjat , PhD;

Brian C. Abraham , MPA;

The acceleration of digital health adoption due to COVID-19 has been welcomed by patients, health care providers, and manufacturers, particularly as governing bodies have been slow to adapt these emerging...

The...

12/16/2020

Journal of Clinical Pathways

Clinical Pathways GPS

Making the Case for Genetic Testing in Clinical Pathways

10/21/2020

Richard G. Stefanacci , DO, MGH, MBA, AGSF, CMD;

Medicare’s coverage for genetic testing is based on each test meeting a “reasonable and necessary” criteria. The decision on whether to order the test depends on real-world patient needs and what existing literature...

...

10/21/2020

Journal of Clinical Pathways

Clinical Pathways GPS

Population Health Partnerships to Advance Value-Based Care

09/18/2020

Richard G. Stefanacci , DO, MGH, MBA, AGSF, CMD;

The business model for health care in the United States is evolving from a volume-driven model to a consumer-centric, value-driven model. As such, there are new competencies required of hospitals and health systems...

The...

09/18/2020

Journal of Clinical Pathways

Clinical Pathways GPS

Government Involvement in Direct Utilization Management, Push for Value-Based Approaches

08/19/2020

Richard G. Stefanacci , DO, MGH, MBA, AGSF, CMD;

Physicians are being forced to the weigh risks vs benefits of previously routine treatments and procedures in light of capacity concerns and COVID infection risk. While Medicare fee-for-service has historically had...

...

08/19/2020

Journal of Clinical Pathways

Clinical Pathways GPS

Where Health Systems Are in the Shift to Value: Four Categories

06/17/2020

Richard G. Stefanacci , DO, MGH, MBA, AGSF, CMD;

One could make the argument that there are four situational categories under which all health systems now fall on the journey toward more value-based care and away from the fee-for-service model. Assisting health...

One...

06/17/2020

Journal of Clinical Pathways

Clinical Pathways GPS

How COVID-19 Will Change the Patient Journey, Reimbursement, and Care Delivery

05/19/2020

Richard G. Stefanacci , DO, MGH, MBA, AGSF, CMD;

Value-based care has led to much change in health care over the years, and COVID-19 is pushing change faster and even further. These changes forced by COVID-19 will have long-term effects on every aspect of care...

...

05/19/2020

Journal of Clinical Pathways

Clinical Pathways GPS

Proactive Steps to Ensure Appropriate Utilization of the First Disease-Modifying Therapy for Alzheimer Disease

03/16/2020

Matthew Pakizegee , PharmD, MS;

Jonathan W. Hodgson , MBA;

Richard G. Stefanacci , DO, MGH, MBA, AGSF, CMD;

Chad McAuliffe ;

Widespread hope exists that aducanumab will soon gain Food and Drug Administration approval as the first disease-modifying therapy for patients with mild cognitive impairment associated with Alzheimer disease (AD),...

...

03/16/2020

Journal of Clinical Pathways

Clinical Pathways GPS

Federal Enforcement of Clinical Pathways, Resource Utilization Management

09/20/2019

Richard G. Stefanacci , DO, MGH, MBA, AGSF, CMD;

Providers order unnecessary tests for a variety of reasons: pressure from patients, fears of malpractice suit, not being knowledgeable about current “best” practices as well as for potential financial advantage for...

...

09/20/2019

Journal of Clinical Pathways

Clinical Pathways GPS

How the Proposed Elimination of Medicare Rebates Would Impact Clinical Pathways

11/18/2018

Richard G. Stefanacci , DO, MGH, MBA, AGSF, CMD;

The Centers for Medicare & Medicaid Services (CMS) has published a range of new proposed and final rules regarding payment rates and policies affecting providers, payers, and patients. The Trump administration...

The...

11/18/2018

Journal of Clinical Pathways