Uncategorized Archives - Page 45 of 92 - BHM Healthcare Solutions

Payer-Provider Joint Ventures Gain Steam

December 5, 2016

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

December 5, 2016

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

November 30, 2016

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

November 28, 2016

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

November 23, 2016

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.

3 Healthcare Trends to Watch for 2017

November 22, 2016

As 2016 comes to a close, now is the time to look at what healthcare trends might bring us into 2017. Current healthcare trends can help healthcare organizations predict changes in the marketplace and isolate places of improvement. From ACOs to behavioral health, here 3 important trends to watch as we enter 2017.

Humana Spent $93M in Quality Payments

November 21, 2016

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.

Healthcare Transformation Assistance Critical in Changing Times

November 18, 2016

The healthcare industry is rapidly changing and growing. Healthcare reform in one of the biggest factors to jump-starts change in all aspects of a healthcare organization. The rapid shift to value based performance and consumer outcomes, from fee-for-service payment, puts Healthcare Transformation Assistance programs and services in the forefront of change. They are designed to assist your organization in this rapidly evolving environment.

Medication Adherence Higher in Patient Centered Medical Homes

November 16, 2016

The Patient Centered Medical Home is very important model of care that has been growing in popularity across the national. The PCMH is not specific place but more a model of care focused on accessible, coordinated, comprehensive, and patient centered care. PCMH are also committed to and is committed to quality and safety. The PCMH model is a great way for primary care organizations to put a stronger emphasis on care coordination and communication, which in turn helps transform primary care to be more patient-centered.

Key Components to a Great Peer Review Training Program

November 15, 2016

Peer Reviews are necessary to remove Conflict of Interest inherent in a healthcare environment by reducing the potential for the organization to make financially driven decisions when applying the Medical Necessity Criteria (MNC) to patient care.

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