How Payers Reduce Wasteful Spending
American Health Policy Institute's released a report describing its work with VBID (Medicare Advantage Value-Based Insurance Design Model) Health. Payers reduce wasteful spending in a number of common sense ways.
Reimbursements and Provider Strategies
Admin inefficiencies keep payers & providers from growing stronger relationships. Provider strategies can lead the way for shaving percentage points off....
Value-Based Care Transition Tough
Value-based care transition tough for providers. They are encountering significant challenges with limited access to claims data, risk-based insurance contracts, as well as investment capital.
Payers Can Drive HEDIS Improvements
Recent articles identified the transition to value-based care as a significant factor for driving up HEDIS scores. Payers can hold providers accountable on how to quantifiably improve health outcomes.
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.
Payers and Providers Value-Based Care Reimbursement
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.
Avoid Clinical Documentation ‘gotcha’s
Clinical documentation is critical for Centers for Medicare and Medicaid Services (CMS) bundles. As CMS adds more bundles to their list, clinical documentation improvements increase in value.
2017 Medical Costs Stabilize
2017 medical costs stabilize near the same rate as 2016. Signs point to larger increases in the future. At least, according to a report going behind the healthcare numbers by...
5 Trends in Business Analytics and Technology that are Improving Healthcare
There has always been change in the healthcare industry, but the pace of change has recently sped up. Medical practitioners are highly knowledgeable and work hard towards being in line with the latest industry research. However, they can’t possibly keep in mind everything they should for each situation. Even with access to massive amounts of data for the comparison of treatment outcomes, they still need expertise, time to analyze that data, and have it integrated with the medical profile of the patient. Such an in-depth research and statistical analysis goes beyond the scope of a physician. While relying on clinical data and claims data has value, there is a great opportunity for organizations to take their health efforts to the next level by integrating both claims and clinical data. Here are the major technological trends in healthcare right now.
Humana Spent $93M in Quality Payments
Humana reimbursed more than $93.6 million to more than 4,000 provider groups countrywide participating in their Provider Quality Rewards Program. These particular healthcare providers received these quality payments due to value-based care improvements.