Health Insurance Archives - Page 7 of 21 - BHM Healthcare Solutions

BCRA, AHCA, and ACA: Winners and Losers

2023-08-13T16:36:41-04:00By Eric Duchinsky|Health Care Reform, Health Insurance, Health Insurance Exchange|

The Senate released its version (a.k.a. Better Care Reconciliation Act BCRA) of the House's AHCA. Payers and providers adjust as needed because healthcare reforms, like BCRA, AHCA, and ACA, continuously move through state and federal legislatures. Today's blog, pulls together summaries from numerous resources allowing you a quick glimpse or a deep dive into what waits around the corner. Here are 10 instances which can help you better identify when its time to look for a partner.

Reducing Behavioral Health Readmissions: Strategies and Lessons Learned

2017-12-01T17:47:35-04:00By Eric Duchinsky|Behavioral Health Integration, Clinical Operations Improvement, Health Insurance, Mental Health Parity, Services, Trends|

Behavioral healthcare cuts both ways for payers and providers. Shortages of qualified expertise makes filling positions difficult to impossible, while the need for services grows on many fronts and in many populations. The Daily Briefing How 2 health systems are rethinking mental health care for a value-based world, from the Advisory Board, reinforces the connections between behavioral and physical health. This identifies tangible targets, like reducing behavioral health readmissions, for improving patient care and institutional financial health.

Growing Turnover Rates Wreck Healthcare Budgets

2017-06-13T20:41:10-04:00By Eric Duchinsky|Clinical Operations Improvement, Health Insurance|

Healthcare is a labor-driven service that depends on the talent and skills of every staff member, from the C-suite to nurses. Finding and keeping this talent is paramount to running a cost-effective organization that provides exceptional care was an observation from an article by Mackenzie Bean by Becker Hospital Review. Growing turnover rates significantly impact profitability.

Lacking Mental Health Expertise Lands 2nd On Scarcity List Two Years Running

2017-06-06T22:47:45-04:00By Eric Duchinsky|Behavioral Health Integration, Clinical Operations Improvement, Health Insurance, Mental Health Parity, Services, Trends|

Payers and providers spend significant energy recruiting and retaining all levels of behavioral health professionals. The access to psychiatrists acts as the 'canary in a coal mine' signalling the impending challenges. Lacking mental health expertise hits organizations at a time of increasing use spurred on by value-based care.

AHCA and Three Scenarios: Repeal, Replace, Repair

2017-05-03T20:18:06-04:00By Eric Duchinsky|Health Care Reform, Health Insurance, Health Insurance Exchange|

Any similarities of the title of this blog and Goldilocks and the Three Bears belies the serious decisions needed for the next round of healthcare reform. Last month, PwC’s Health Research Institute (HRI) released another fantastic research piece that maps out three possible landing spots: repeal, replace, repair. Here are 10 instances which can help you better identify when its time to look for a partner.

New Research Shows ACOs Improve Population Health Management and Re-admission Rates

2017-12-01T11:43:58-04:00By Eric Duchinsky|Accountable Care Organizations, Health Care Reform, Health Insurance|

New research shows that accountable care organizations are partnering with community resources and social service agencies to improve population health management according to a new report from Performance Evaluation: What Is Working In Accountable Care Organizations? Highlights from the study are presented here. Private payers and the alternative payment models they’ve used among accountable care organizations have shown mixed results, but coordinating with social service agencies may bring improvements in population health management. Coordination with community centers will take the hospital-centered approach to healthcare in a significantly and positive direction, the report states.

CMS Pilot Program to Compare Network Breadth of Health Plans

2017-04-02T13:28:00-04:00By BHM Marketing|Health Insurance, Uncategorized|

In April of 2016, CMS announced that a new type of tool to help consumers compare the breadth of plans’ networks on HealthCare.gov. A recent update to that announcement (September 2016) has notified the public that the roll out should start in 2017, for a small number of states.

New Study Reviews Payer Performance

2023-10-09T11:51:52-04:00By BHM Marketing|Care Coordination, Clinical Analysis, Health Insurance|

Athena Health recently published the 2016 edition of Payer View, a in-depth review of the biggest payers in their network. Athena Health identifies the shift to value based care and healthcare reform as the biggest challenges to everyone for payers to providers.

HEDIS Success & Value Based Care

2017-05-17T12:58:53-04:00By BHM Marketing|Health Insurance, Uncategorized|

The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by 90% of the United States’ Health Plans to measure performance on important elements of care and service. HEDIS standardizes the way health plans collect, analyze, and report data. It creates an equal playing field for all health plans (who use HEDIS) to be compared. It also can be used by employers, consultants, and patients to find the best health plan match for their needs. Many payers are now using value based reimbursement models to help meet HEDIS benchmarks. These value based programs make providers accountable for closing gaps in care and meeting HEDIS measures.

NCQA Releases Health Insurance Plan Ratings for 2016

2023-09-08T15:46:23-04:00By BHM Marketing|Health Insurance, Uncategorized|

On September 22, 2016 the NCQA announced the release of the 2016-2017 Health Insurance Plan Ratings, this is the second year of the NCQA's new rating methodology. The Health Insurance Plan Ratings. which are published annually and compare the quality and services of more than 1,000 health plans across the United States. One new aspect of the 2016-2017 ratings is that WebMD will be publishing the ratings on their WebMD.com.

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