Blog 2017-04-02T13:27:54+00:00

Provider-Sponsored Health Plans: Executive Perspectives

By | July 12th, 2017|Categories: Health Care Reform|Tags: , , , , , , |

Provider-sponsored health plans struggle through the ever-changing political environment. For providers hoping to get a handle on healthcare costs and supplement their own medical data with claims data, launching a health plan has been a strategic move.

5 Medical Cost Pressures Shaping 2018

By | July 11th, 2017|Categories: Financial, Financial Analysis, Health Insurance, Revenue Cycle Improvement, Trends, Uncategorized|Tags: , , , , |

The era of volatile swings and double-digit growth in employer medical costs appears to be ending. With medical cost trend hovering in the single digits for several years, the industry has been waiting for the inflection point when spending will take off. But that spike appears unlikely to happen. The New Health Economy is settling into a “new normal,” typically characterized by more attenuated fluctuations and a single-digit trend.For four years, medical cost trend has hung between 6 and 7 percent, seeming to settle into a “new normal.” PwC’s Health Research Institute (HRI) anticipates a 6.5 percent growth rate for calendar year 2018, half a percentage point higher than in 2017.

Highly Successful ACOs: 3 Innovative Best Practices

By | July 4th, 2017|Categories: Clinical Operations Improvement, Health Insurance|Tags: , , |

 The URAC Report stated Accountable care may still be a relatively new model in some areas, but the numbers of highly successful ACOs are steadily increasing. There were approximately 660 ACOs in the U.S. in 2015. The number increased to 838 last year. Success, however, can be elusive.

Margin Defense & Revenue Cycle Management: 8 Challenges

By | July 4th, 2017|Categories: Big Data, Financial Analysis, Health Insurance, Lean Management|Tags: , , , , |

Payers and providers connect, both formally and informally, through the reimbursement process. In past times, the relationships were stormy. Today, market forces push the need for better understanding of margin defense and revenue cycle performance. Streamlining internal operations addresses many of these new market demands. For example, patients demand higher value for care pushing more review of claims which push greater need for consistent documentation.  

Health Trends Highlights: Health, United States Annual Report

By | June 29th, 2017|Categories: Clinical Operations Improvement, Organizational Analysis, Trends|Tags: , , , , |

Over the past 40 years Health, United States provided an annual picture of the health of the United States, identified variations in health status, modifiable risk factors, and health care utilization among people by age, race and ethnicity, gender, income level, and geographic location. Examining long-term health trends inform the development and implementation of effective health policies and programs.

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