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Bridging the Gap: How Targeted Interventions Improved Mental Health Outcomes for Medicaid Members
3 min read

Bridging the Gap: How Targeted Interventions Improved Mental [...]

For over 75 years, May has been recognized as Mental Health Awareness Month, an annual observance dedicated to highlighting the importance of mental well-being, educating the public, reducing stigma, encouraging early intervention, and supporting those affected by mental health conditions. 
Proactive, Not Reactive: The Payer Perspective on Women’s Preventive Health
2 min read

Proactive, Not Reactive: The Payer Perspective on Women’s [...]

Women sit at the center of the healthcare ecosystem, not only as patients, but as decision-makers and caregivers. Women make approximately 80% of healthcare decisions for their families (Becker’s Hospital Review), a statistic that underscores the importance of ensuring their access to consistent, high-quality preventive care. 
2026 Rate Announcement: MTM Update
2 min read

2026 Rate Announcement: MTM Update

The 2026 Rate Announcement released on 4/7/25 included a decision from CMS not to retire the CMR completion rate measure. While CMS acknowledged stakeholder feedback opposing retirement without an outcomes-based replacement, they confirmed the measure will remain on the display page due to the expanded MTM eligibility requirements.

Early Preview: Insights and Results from the MTM Expansion
4 min read

Early Preview: Insights and Results from the MTM Expansion

In order to expand the population eligible for MTM, CMS modified criteria requirements by establishing an expanded list of targeted disease states and reducing the drug spend threshold.

Final Rule Details
8 min read

Final Rule Details

The Final Rule was released on April 4, 2024 detailing updates to criteria utilized for MTM Program enrollment effective January 1, 2025.
The Top 3 Areas Payers Should Focus on to Raise the Bar in 2024
5 min read

The Top 3 Areas Payers Should Focus on to Raise the Bar in 2024

Here are three clinical areas that payers and their pharmacy care partners will need to emphasize in 2024.
Proposed Rule Summary - Medicare Advantage 2025 Proposed Rule
6 min read

Proposed Rule Summary - Medicare Advantage 2025 Proposed Rule

The proposed rule is a detailed outline of all changes and provisions that CMS proposes to make to the Medicare Advantage program in 2025 and beyond.
Why Payers Need Robust Medication Adherence Strategies
5 min read

Why Payers Need Robust Medication Adherence Strategies

Let's discuss the issue of nonadherence and what payers can do to improve these numbers and help more patients. 
Pharmacy Solutions For Formulary Optimization
4 min read

Pharmacy Solutions For Formulary Optimization

Formulary management can result in significant savings for health plans and combat rises in prescription drug prices.
Outcomes Collaborates with CaringWire to Provide a New Personalized Approach to Healthcare Needs
1 min read

Outcomes Collaborates with CaringWire to Provide a New [...]

In this blog, we will discuss how Outcomes has collaborated with CaringWire.

Unlocking the Value of Outcomes
2 min read

Unlocking the Value of Outcomes

Pharmacists are emerging as pivotal players in healthcare. They have the opportunity to provide care that expands their impact beyond dispensing meds.
Pharmacists Provide Critical Interventions During Transitions of Care
7 min read

Pharmacists Provide Critical Interventions During Transitions of [...]

There’s opportunity for pharmacists to help avoid the medication errors that occur during a patient's transition of care.
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