Resources by BHM Healthcare Solutions

Autism Care Costs: Healthcare’s Perfect Storm

August 1, 2017

Autism care costs balance in the middle of many competing issues and agendas leaving payers, providers, and consumers trying to sort out the facts from fictions. The size of the funding pie “…over the next 10 years [is] about a half a million youth with autism spectrum disorder (ASD) will enter adulthood. The majority of the costs in the U.S. health care systems for ASD are directed at the adult population: $175 to $196 billion for adults compared to $61 to $66 billion for children.” writes Monica Oss, CEO, Open Minds.

Cyber-attacks: Not A Matter Of “If”, But “When”

August 1, 2017

The KPMG 2017 Cyber Healthcare & Life Sciences Survey of providers and health plans found a dramatic rise in computer system breaches, cyber-attacks, and data compromises, which include patient records, over the past two years. Despite that increase, more executives, who oversee protecting patient records and other information, say they are better prepared than two years ago to protect themselves against cyber-attacks.

Insurance Coverage Improve Health Outcomes In Four Ways: NEJM

July 25, 2017

The national debate over the Affordable Care Act (ACA) has involved substantial discussion about what effects — if any — insurance coverage has on health and mortality. Health plans play a leadership role in healthcare reforms. While debate continues, a recent piece in the New England Journal of Medicine answers one main question. Does having insurance coverage improve health outcomes?

Health Plans Create Best Practices: New Opioid Crisis Report

July 25, 2017

Health plans create best practices and lead with concrete strategies for preventing opioid overuse. The Association for Community Affiliated Plans (ACAP) recently issued a report detailing the innovations and best practices of its member Health Plans in their efforts to combat opioid misuse and overuse. The opioid epidemic led to an estimated 33,000 deaths and more than 300,000 emergency room visits in 2015, and recognized as a subject of intense debate on Capitol Hill and in statehouses around the country.

Key Payer Competitive Differentiator: Analytics

July 20, 2017

Many health plans are facing uncertainties: the changing health insurance landscape, the speed at which value–based care is approaching, and growing demands from customers, to name a few. But one investment may help executives meet each of these challenges—an investment in analytics. Health plans are data rich, yet those data are not always leveraged to understand what happened and why, or predict what is likely to happen. Health plans that don’t take advantage of their data may risk being disrupted and left behind. Analytics can be a key payer competitive differentiator setting your organization ahead of the pack.

Health Systems Financial Futures at Risk: New National Survey Results

July 20, 2017

According to a new report, prominent factors are challenging small hospitals and health systems financial futures and notes organizations can address these obstacles through a transformation leading to a competitive advantage and better health outcomes for patients.

EHR Documentation Stretching Reimbursement Cycles?

July 18, 2017

Payers and providers need efficient administrative services for profitability. With all the capital and human resources invested in electronic health records and data exchange security, why are documentation errors still one of the highest cause of adverse determinations? The number of claims slowed by lack of/incomplete/poor EHR documentation became crystal clear in recent reports.

Payers Increasing Member Value Through Payment Initiatives

July 18, 2017

The healthcare industry is undergoing an inevitable shift away from fee for service payment models towards reimbursement models that align with the healthcare triple aim, such as value based payments. The approach and question of which value-based model to implement still remains elusive for many organizations. Let’s take a look at some payment types on the value-based reimbursement spectrum.

Provider-Sponsored Health Plans: Executive Perspectives

July 12, 2017

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.

Security Program Answers To Five Vital IT Questions

July 11, 2017

The most important strategic security program decision that the organization can make is the framework that the organization adopts for its cyber-security and compliance program.

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