Challenges of Developing Workers Compensation Treatment Guidelines

Workers compensation treatment guidelines can help prevent unnecessary medical procedures and the prescribing of potentially harmful medications. However, they are not all the same, nor are they without challenges. Understanding a jurisdiction's strengths/weaknesses, taking a strategic approach to developing guidelines, and using common sense can lead to better outcomes for injured workers—and, ultimately, lower costs for payers.

Update: Payer Efforts Against Opioid Epidemic

According to the CDC, drug overdoses are the leading cause of accidental death in the United States. Of the overdose deaths that occurred in 2015, 63 percent involved an opioid. Payer options for managing efforts against opioid overuse range from monitoring population data to working with provider networks.

Payer-Provider Joint Ventures Gain Steam

An article in Managed Healthcare Executive, reports that joint ventures are gaining steam as plans and providers look for ways to work together to provide higher-value care. About 13% of all U.S. health systems offer health plans, covering about 18 million members—or 8% of insured lives. according to a report from McKinsey & Company. Also according to the company, the number of provider-owned health plans is increasing about 6% each year.

By | 2017-04-02T13:27:57+00:00 December 5th, 2016|Uncategorized|0 Comments

Strategies for Payer Negotiation

When it comes to procuring and maintaining your contracts with payers, there is perhaps no skillset greater to possess than that of the art of negotiation. In today’s healthcare market, there’s not only a need to be informed and competitive, but healthcare organizations need to have a very clear understanding of where they stand amid the competition.

By | 2017-04-02T13:28:19+00:00 April 9th, 2015|Financial, Financial Analysis, Services|Comments Off on Strategies for Payer Negotiation

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