Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability
  • UnitedHealthcare Partners with Accountable Care Organizations

    January 20, 2017 - In December, UnitedHealthcare announced in a company press release the release of NexusACO, a new health plan option for self-funded employers that is available in 15 markets. Tier 1 of NexusACO involves offering healthcare access to members from physicians affiliated with accountable care organizations (ACOs). HealthPayerIntelligence.com spoke with Reed Bjergo, Chief of Staff at UnitedHealth...

  • Value-Based Care Drives Progress in Population Health Management

    January 18, 2017 - Population health management is becoming a more prominent topic of interest among healthcare payers as they strive to transition to value-based care reimbursement and improve patient outcomes. A report from the Institute for Health Technology Transformation sponsored by IBM Watson outlined how many healthcare systems are investing in population health management by partnering with accountable...

  • Prospective vs. Retrospective Healthcare Bundled Payment Models

    January 11, 2017 - When implementing healthcare bundled payment models, providers and payers have two main strategies to choose from: prospective or retrospective bundles. A prospective healthcare bundled payment model involves creating a budget when the episode of care criteria are reached. The fee is then paid to the provider organization or an intermediary like an accountable care organization to distribute...

  • Why Healthcare Bundled Payment Models May Expand in 2017

    January 9, 2017 - The Centers for Medicare & Medicaid Services (CMS) have advanced bundled payment models by implementing these value-based payment structures in orthopedic and cardiac care. CMS released a finalized bundled payment model for cardiac and orthopedic care in December 2016. CMS also published a report in September 2016 about the Bundled Payments for Care Improvement (BPCI) program, which shows...


Today's Top Stories

UnitedHealthcare Partners with Accountable Care Organizations

In December, UnitedHealthcare announced in a company press release the release of NexusACO, a new health plan option for self-funded employers that is available in 15 markets. Tier 1 of NexusACO involves offering healthcare access to members...

Top 3 Reasons to Partner with Accountable Care Organizations

With value-based care reimbursement becoming the standard across health insurance companies and medical facilities around the country, stakeholders are investing more time and resources in accountable care organizations (ACOs). Why should healthcare...

How to Reduce Obesity Rates, Increase HEDIS Quality Scores

When attempting to improve provider performance on HEDIS quality scores, healthcare payers may need to pick and choose the quality measures that could be realistically raised. For example, childhood obesity may be one of the most common health...

UnitedHealthcare Adopts Bundled Payment Model for Surgeries

The national health insurance company UnitedHealthcare has followed the lead of the Centers for Medicare & Medicaid Services (CMS) and implemented a bundled payment model specifically for hip, spine and knee surgeries much like...

Value-Based Care Drives Progress in Population Health Management

Population health management is becoming a more prominent topic of interest among healthcare payers as they strive to transition to value-based care reimbursement and improve patient outcomes. A report from the Institute for Health Technology...

Aetna, Humana, Harvard Pilgrim Target Patient Health Outcomes

Commercial health insurance companies have pursued a number of different approaches to improve patient health outcomes and reduce wasteful medical spending. The payers Aetna, Humana, and Harvard Pilgrim conducted some key collaborations to achieve...

Why Payers Should Reduce Cost Sharing for High-Value Care

Today, more healthcare payers are positioning greater cost-sharing onto the consumers to keep from raising premium rates, according to commentary published in JAMA Internal Medicine. The 2016 National Health Insurance Survey discovered that 40...

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