In response to my post on payers shifting medical management strategy decision-making from experts to non-experts, a longtime friend and colleague provided his perspective. With 40 years in roles ranging from regulator to compliance consultant to operations exec for payers, states, vendors and employers, he has a depth of knowledge that demands your respect and attention.
Here’s his view [with my edits for clarity]:
Over the last several years, states have continued to outsource their medical management policy development and implementation.
Initially, this was in the area of trea...
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