My areas of expertise include occupational therapy, healthcare, exercise, health insurance, nutrition, mental health, rehabilitation, telemedicine, orthopedics, pediatrics, neurology, and health tech.
Exploring the Untapped Potential of Effective Provider Network Management for Health Insurance Executives
Navigating the intricate dance of network adequacy, provider relationships, and regulatory compliance can feel like a continuous tightrope walk. These responsibilities are crucial for member satisfaction and organizational health, yet they often need to be juggled alongside pressing deadlines and competing priorities. However, effective provider network management emerges as a powerful tool in the repertoire of astute health insurance executives.
Unlocking Value Through Health Care Provider N...
Supporting Drivers with Disabilities (AOTA-approved continuing education course)
Transportation as a whole is a vital way for individuals to access and explore their environment. Transit is a necessary prerequisite for most people to engage in leisure activities, socialize with others, fulfill work and volunteer roles, and maintain their health. While there are several methods of public transportation including buses and trains, driving a vehicle is personally meaningful to many individuals. This personal connection is due in part to the independence and convenience it affords a person and those around them.
Prepare for Medicaid Access Changes: What Your Health Plans Need to Know Now
Network inadequacy can create a big headache for health plans, so payers should give special attention to any legislative changes (either proposed or finalized) to these policies. One potential change is related to Medicaid and managed care access standards. Since the overwhelming majority (72%) of Medicaid beneficiaries are also managed care members, these standards could have a big impact on how this population receives care.
Legislation Highlights
In 2023, the Biden administration proposed...
Reflexes and Evidence-Based Practice (AOTA-approved continuing education course)
Over the years, there have been many ‘hot topics’ in the therapy world. Most often these involve topics influenced by current events or new developments in clinical areas that the occupational therapy field has not yet taken a stance on. Reflex integration therapy is one such area that has remained a hot topic for some time. The main reason for this is because its level of acceptance varies based on the age group and population it is used to treat.
Record-Breaking ACA Enrollment: What It Means for Your Health Plan
Estimated Read Time: 3 Minutes
The Affordable Care Act has hit a historic milestone! Over 20 million Americans are now enrolled in individual marketplace plans – nearly 6% of the population. In 2023, there were 16.3 million individuals enrolled in these plans, which means this year’s figures jumped almost 4 million. This marks a significant turning point for health care access.
Of the new enrollees, 3.7 million are experiencing the ACA for the first time, while 16.6 million switched or renewe...
Infectious Disease Cases are Rising: How Can Your Health Care Provider Network Act as a Buffer?
Estimated Read Time: 5 Minutes
Learn how your health care provider network can:
Identify community hot spots & engage vulnerable populations.
Craft engaging educational content for optimal reach & impact.
Boost patient engagement & safety through testing & wellness tools.
Health Care Provider Networks Must Respond to the Rapid Spread of Infectious Disease
Rates of COVID-19 and respiratory syncytial virus (RSV) are, once again, on the rise. In the last week of December 2023, 3.6% of all deaths...
Preventive Vision Care Can Lead to Better Brain Health Outcomes
A new study from the Journal of American Medicine: Ophthalmology shows that all types of visual impairments are associated with a higher risk of dementia. Between 12 and 32% of individuals with visual impairments are also diagnosed with dementia. This variation in the prevalence is due to the range in severity of visual conditions, which is typically associated with poorer outcomes. This study also found a stronger connection between having multiple visual impairments and developing dementia ...
Pain Management and its Impact on Occupational Therapy Treatment (AOTA-approved continuing education course)
Pain management is an important topic for occupational therapists since it impacts many aspects of the evaluation and treatment process. Any form of pain can negatively influence a person’s occupational performance and quality of task completion along with their overall physical and mental health. As a result, therapists should be well-versed in the mechanisms of pain along with evidence-based management strategies for each type of pain their patients may experience.
Managing an Increase in Pharmaceutical Spending on Specialty Drugs
A recent report by Vizient expects that hospitals will see a nearly 3.5% increase in pharmaceutical spending next year. Much of this increase can be attributed to medications for diabetes and neurological conditions, along with specialty drugs such as those for cancer treatment. Among those drugs impacted include medications that treat multiple sclerosis, migraines, rheumatoid arthritis, and Crohn’s disease.
On the other hand, a few medications are expected to decrease in cost. One such drug ...
Medicare Begins Historic Price Negotiations for Popular Medications
For the first time in its nearly 60-year history, Medicare began negotiating prices for ten widely prescribed drugs. Negotiations began in September 2023, and are a direct response to the recently passed Inflation Reduction Act. The proceedings, which will run from 2026 to 2028, are expected to address some of the nation’s most costly drugs. However, there is a lot of speculation regarding exactly which drugs will undergo negotiations first.
The first ten medications to be reviewed will be se...
Insurer Considerations Becoming Crucial Amid Wearable Technology Growth
Wearable technology has become a staple in many American households over the past few years. Fitness trackers are especially popular among individuals looking to monitor their basic vital signs and increase their physical activity. Wearable technology has even become sophisticated enough to assist with implementing medical services.
This is where wearable patches have entered the playing field. Wearable patches differ from other wearable technology in that they are used to assist with diagnos...
Moral Distress: Coping with Ethical Challenges in OT Practice (AOTA-approved continuing education course)
Ethics in healthcare is a fundamental topic for providers to be educated on. While many aspects of ethics – both in rehabilitation, healthcare as a whole, and in a general sense – do not change, ethics tends to be a nuanced topic. This is partially because ethical scenarios do not always have an obvious solution. At times, providers may even find that many possible courses of action are associated with their unique drawbacks. For this reason, ethics and moral distress are closely related. Both moral distress and ethics are influenced by organizations, payers, societal trends, and more.
Important Considerations for the Evaluation and Treatment of Posttraumatic Stress Disorder (PTSD) in Veterans (AOTA-approved continuing education course)
In order for therapists to effectively treat veterans, they must not only have a working knowledge of PTSD, but they must also understand how this condition impacts the treatment they provide. This course will offer therapists a look at diagnostic information related to PTSD, considerations that impact evaluation and treatment, and other resources for veterans living with this condition.
How Insurers Can Minimize Effects of Unexpected Medication Shortages
Many companies (including but not limited to health care organizations) experienced the negative effects of supply chain shortages during the COVID-19 pandemic. However, there are other reasons for such supply issues.
The most recent shortage has impacted many prescription medications and is attributed to a tornado damaging a Pfizer factory in North Carolina. Hospitals were particularly anxious about this incident, which led some of these large organizations to overbuy. This response only wor...
Adult ADHD (AOTA-approved continuing education course)
According to the National Institute of Mental Health, an estimated 8.1% of adults will experience ADHD between the ages of 18 to 44 years. Adult ADHD impacts an individual’s abilities to participate in their work, education, and personal lives. Additionally, adults with ADHD are more likely to experience depression, mood or conduct disorders, and substance use disorders. Due to the effects of ADHD across the lifespan, adults with this condition are at risk of experiencing limitations in functioning at work, school, in relationships, and in their home lives.