The American journal of managed care
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Most Americans have insurance that uses managed care arrangements. Regulators have long sought to ensure access to care through network adequacy regulations. However, consumers have largely been excluded from conversations about network adequacy. To our knowledge, our study is the first to assess consumer preferences for various definitions of network adequacy including those aimed at supporting health equity and reducing disparities. ⋯ Our findings indicate that consumers have broad conceptions of network adequacy. Future work should assess consumer trade-offs in resource-constrained settings as well as perceptions of providers and carriers.
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High health care prices cause significant harm to individuals, businesses, communities, and society at large. These harms include reduced access to care, rising medical debt, lower wages, more inequity, and a growing burden on businesses and governments. ⋯ Catalyst for Payment Reform and the Employers' Forum of Indiana's new campaign, Price Crisis, will mobilize individuals, employers, and policy makers with evidence, guidance, and resources to take meaningful actions through marketplace initiatives, policy advocacy, and antitrust enforcement. The following article is written from the perspective of Catalyst for Payment Reform.
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This article examines how predictive analytics can enhance payer initiatives to improve medication adherence. Despite its known impact on health outcomes and costs, medication nonadherence remains a widespread and persistent challenge in health care. ⋯ The potential benefit of this approach includes prevention, not only resolution, of nonadherence and leads to improved health outcomes, reduced health care costs, and increased member satisfaction. The article also discusses potential caveats to consider, such as data sharing, bias mitigation, and regulatory compliance, when implementing predictive analytics in this context.