Across America a change in the healthcare landscape is marked by the emergence of both public and private Accountable Care Organizations (ACOs). In fact, the number of ACOs in the U.S. has grown from 64 in 2011 to 744 in 2015. Hoping to shift the focus of the healthcare industry from volume to value, ACOs focus on increasing quality, reducing, cost and improving the patient experience. This focus is called the Triple Aim.
Aetna is setting a new standard for healthcare partnerships as it joins forces with a north Texas health system in hopes of focusing on improving quality care, affordability and overall patient care. Partnerships are no stranger in the healthcare world, but insurers and providers partnering up to provide better care and better coordinate care, is a trend we expect to see grow in 2016.
The concept of continuous improvement is widely known throughout the healthcare world. When it comes to peer review programs, it can make or break a claims process. A peer review partner can help ensure that your organization stays up-to-date on technology cycles, legislation changes, and any other important shifts in the healthcare industry.
In 2014 more than 14,000 people died from prescription opioid overdoses* and the numbers are not decreasing. Prescription Drug Monitoring Programs and the analysis of patient data, are two ways the healthcare industry is fighting the opioid epidemic.
The opioid epidemic is a real concern, not only for the patients and providers but also for payors and health plans. According to a study by the Centers for Disease Control and Prevention, there could be correlation between insurers picking up the costs on pain drugs and the rise of opioid related deaths.
The Centers for Medicare & Medicare Services (CMS) values data. And with the update of their data initiatives, it will now be more transparent and easier to access. Your organization will now be able to benchmark against some of the biggest health systems in the country. Data is crucial for measuring costs, services and trends, especially when it comes to organizational growth.
The healthcare industry has undergone major changes since the rollout of the Affordable Care Act and now a new type of reimbursement model is putting traditional incentive based payment models on the shelf for good. Value based reimbursement, which ensures that providers are rewarded for performance, quality, and cost reduction (instead of number of services provided), is a model that will help shape the future of healthcare.
The multifaceted world of accreditation can be daunting, from choosing the right accreditation body to getting correct documentation in place to ensure accreditation success. Here are 7 tips to keep you on track and lower first time accreditation risk.
Health insurance claim denials cause many healthcare organizations to lose a significant amount of money each year. In fact, large health organizations frequently lose millions of dollars per year due to ineffective denial strategies.
Behavioral health integration in primary care has been one of the biggest healthcare trends in 2016 so far. From cracking the stigma surrounding mental health to paving the way for better access to behavioral health related services, integration is making waves in all facets of the healthcare continuum. 2016 will be an important year for Behavioral Health integration with everyone employers to payors recognizing the importance of treating mental health issues in a primary care setting.
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