Last year, we published a blog about Washington State's IRO Transparency Project. As the ACA evolves into the next phase of healthcare, states continue using tools and resources developed over the past five years. BHM's continues in its role as a leader in IRO services with an update on Washington's project.
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.
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.
Rural Hospitals Face Financial Pressure according to a recent article
MOUNT VERNON, Texas—Despite residents’ concerns and a continuing need for services, the 25-bed hospital that served […]
2016 is going to be a big year for Behavioral Health, thanks to The Excellence in Mental Health Act (ExACT) passed in 2014. the ExACT is a crucial step towards taking Behavioral healthcare off the back burner and sparking an important discussions on mental health. According to the National Council for Behavioral Health the program will “increase Americans’ access to community mental health and substance use treatment services while improving Medicaid reimbursement for these services.” The program has allocated over $1 billion to help protect and enhance community based mental health programs, which is the largest federal investment in behavioral health services in a very long time. Let’s take a look at the progress the Excellence in Mental Health Act has already made and what might be in store for 2016.
In recent years there have been exciting innovations around the Independent Review Organization industry. Recognized by the Affordable […]
Over the past year we have seen many changes in healthcare at the local, state, and federal level. […]
2015 has been a big year of change for many healthcare systems. With this change, healthcare leaders have been faced with many challenges, including complying with new federal regulations and making strategic moves towards better care. We've compiled a list of the five biggest challenges we've found healthcare leaders facing this year.
Gwen Roberts, Senior Vice President of BHM Healthcare Solutions, Inc. was recently interviewed by PracticeSuite as part of their […]
As we continued to move toward value based purchasing, healthcare as an industry is becoming more and more focused on population health metrics. Instead of looking at smaller patient populations and sample sizes, industry researchers and leaders are casting a wider net these days, hoping to capture larger data samples and establish benchmarks for the move away from current payment models.