Population Health and Care Management

The term “population health” began emerging in U.S. health care circles around March 2003 when David Kindig and Greg Stoddart co-authored an article in the American Journal of Public HealthCare Management entitled…

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Wrapping Your Arms Around the Medical Benefit Drug Spend

Prescription drugs are covered through a health plan’s pharmacy or medical benefit. This determination depends on whether the drug is self-administered or given in a clinical setting. While the reimbursement process through the pharmacy…

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Why Member Experience? And Why Now?

Recently, I was having a drink with a friend in the industry, and I started talking about our member experience roadmap. My friend made the mistake of asking me why I was…

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Taking the Pulse of Your Population

How well do you know your members? Member segmentation, or stratification, is the foundation of your population health management strategy. Member wellness, healthcare facility utilization, and provider patient management are some of…

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