Population Health Data

Social Determinants of Health Generate Drastic Cost Reductions

2018-05-30T00:25:42-04:00By |Managed Care, Population Health, Trends, Uncategorized, Utilization Management|

New research released by WellCare Health Plans, Inc. and the University of South Florida (USF) College of Public Health, Tampa, and published in Population Health Management, reports that healthcare spending is substantially reduced when people are successfully connected to social services that address social barriers, or social determinants of health, such as secure housing, medical transportation, healthy food programs, and utility and financial assistance.

Social Determinants Vital To Payer Improvement

2017-12-19T18:50:38-04:00By |Managed Care, Population Health, Trends, Uncategorized, Utilization Management|

A report from Blue Cross Blue Shield Association, was released linking social determinants of health to differences in health across communities. From this report payers can see how demographic, behavioral, and structural factors impact health conditions of their members in different ways and gain greater insight into these differences to better understand population’s overall health.

Health System CEOs Share ‘What Keeps Them Awake’ In Survey

2017-12-12T18:52:47-04:00By |Lean Management, Operational Analysis, Organizational Analysis, Population Health, Trends|

CEOs at hospitals and health systems are faced with increasing headwinds as they look to move forward in an uncertain environment. So what are the key issues and trends CEOs are facing? Deloitte interviewed 20 health system CEOs this year to find out. While none of the key themes emerging from our interviews have really changed since Deloitte last spoke with health system CEOs, the urgency certainly has. Instead of thinking about these issues in a futuristic sense, CEOs are ready to address and tackle them now. 

Drug-Related Risks and Outcomes: 1st Annual National Report

2017-09-05T18:03:16-04:00By |Big Data, Managed Care, Population Health, Trends, Uncategorized|

The purpose of this first annual surveillance report is to summarize the latest information available on the national level for various drug-related risks and health outcomes, health behaviors, and prescribing patterns related to the drug problem in the United States. The most recent year of information available is different for different outcomes. The emphasis is on national information, but some state information is also presented. This document is intended to serve as a resource for payers, providers, and pharma companies charged with addressing this ongoing national problem. It will be updated annually.

Social Determinants: Payer Cases Improving Member Health

2017-08-23T17:31:18-04:00By |Managed Care, Population Health, Trends, Uncategorized, Utilization Management|

Currently, payer strategies focus on finding healthy populations, segmenting the markets, and segmenting populations, with the target of avoiding costly procedures. Population management and all the big data trends became useful tools in those payer strategies. With the results from a study by the Robert Wood Johnson Foundation and a position paper by America's Health Insurance Plans (AHIP), social determinants quickly rose as the next measurable data used by payers.

Payers and Providers Value-Based Care Reimbursement

2017-09-20T17:09:35-04:00By |Population Health, Revenue Cycle Improvement, Uncategorized|

Value-based care reimbursement models (VBR) are becoming a popular choice for many healthcare providers and payers, as fee-for-service, (and traditional incentive based payment models), are phased out. According to a recent McKesson survey “Journey to Value: The State of Value-Based Reimbursement in 2016," 58% of payers and hospitals are planning to adopt value-based care reimbursement models.

The Opioid Epidemic: Health Insurance Companies Join the Fight

2023-08-08T14:51:54-04:00By |Behavioral Health Integration, News and Events, Population Health, Quality Improvement Programs|

According to the Centers for Disease Control, an estimated $25 billion of U.S. healthcare costs was attributed to the abuse of painkillers—otherwise known as opioids. Up to 36 million people worldwide struggle with opioid addiction. CNN recently revealed that health Insurance companies alone lose a total of $72.5 billion annually due to of opioid addiction. Cigna is the most recent health insurance company to join the fight. By using patient data they are hoping to target overprescribing of prescription painkillers. Monitoring patient data and prescription history Cigna flags high-risk customers and notifies doctors about the patient’s history of opioid use or their high-risk behavior which puts the patient at risk for new prescriptions.

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