Brittany Ferri

Recent legislation proposed by the Biden administration aims to address member dissatisfaction with insurance approval wait times. If passed, this rule will apply to prior authorization requests through government insurance plans and could go into effect starting in 2026 for Medicaid and Medicare members.
Prior Authorizations Associated with Cost Savings
In previous years, some experts have contentiously debated the utility of prior authorizations since they often lead to more paperwork for p...

With ongoing medication shortages and astronomical costs for specialty drugs, nearly all members can benefit from medication savings. Furthermore, managing costs helps payers keep reimbursement rates steady for their partners. TOG has identified several tools that can help with cost-saving efforts.
Leverage proof-of-delivery for medication transport
Proof-of-delivery is just one tool payers can use to enhance security for members receiving medications in the mail, which undoubtedly improves m...

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...

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.

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...

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.

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...

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...

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 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.

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 ...

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...

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...

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.

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.