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Value-Based Care News

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...


Articles

Top 3 Reasons to Partner with Accountable Care Organizations

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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...

Value-Based Care Drives Progress in Population Health Management

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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...

How 3 Healthcare Insurers Expand Value-Based Care Payment

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National health plans are leading the way in alternative reimbursement structures such as bundled payment models and shared saving programs. Blue Cross Blue Shield health plans, Cigna, and UnitedHealthcare have worked to expand their value-based...

3 Ways Bundled Payment Models Brought Hospital Cost Savings

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Case studies of bundled payment models show significant cost savings among hospitals and both public and private health insurers. The Centers for Medicare & Medicaid Services (CMS), for instance, invested in bundled payment models for lowering...

Prospective vs. Retrospective Healthcare Bundled Payment Models

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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...

5 Best Practices to Advance Value-Based Care Reimbursement

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When payers begin to transition to value-based care reimbursement from the more traditional fee-for-service payment system, company executives and financial experts may find it takes longer than expected to adopt the new payment structures while...

Medical Organizations Advise Changes for Quality Payment Program

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The healthcare provider community has shown some concern about MACRA implementation and the quality payment program. The Advisory Board released a survey last month showing that 70 percent of 30 medical groups were concerned about MACRA regulations...

Accountable Care Organizations May Improve Diabetes Management

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Diabetes is a major public health concern for the medical industry with 29.1 million Americans or 9.3 percent of the population diagnosed with the disease in 2012, according to the American Journal of Managed Care (AJMC). In fact, the American...

70% of Medical Groups Concerned About MACRA Regulations

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MACRA regulations have impacted the revenue cycle of providers across the country particularly regarding Medicare reimbursement from the Centers for Medicare & Medicaid Services (CMS). The American Academy of Family Physicians outlined how...

5 Solutions for Conquering Challenges of Bundled Payment Models

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Despite strong optimism and stakeholder enthusiasm, a new bundled payment program operated by the Integrated Healthcare Association and the RAND Corporation faced major problems and delays. A report from the Agency for Healthcare Research and...

Communication Key for Transition to Alternative Payment Models

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Along with health insurers, more and more providers are expected to transition to alternative payment models (APMs) especially due to MACRA’s Quality Payment Program. For example, urology group practices are likely to adopt advanced alternative...

4 Major Ways to Succeed in Value-Based Care Payment Strategies

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What areas should payers and providers focus on when contracting through a value-based care payment strategy? In order to succeed in value-based care payment models, insurers and practitioners may need to focus on population health management,...

Population Health Management Helps ACOs Earn Shared Savings

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Continually rising medical costs without significant benefits to patient care have led both public and private payers to invest in value-based care payment structures such as accountable care organizations (ACOs). However, when payers and providers...

MACRA Pushes Payers to Adopt Value-Based Care Payment Models

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This past summer, the Labor Department announced that healthcare spending rose in August more steeply than at any point in more than 30 years. The costs for medical treatment grew by 1 percent in just one month, the Los Angeles Times reported....

UnitedHealth Releases Accountable Care Organization Coverage

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On December 7, UnitedHealthcare announced in a company press release the introduction of the NexusACO, which is a new health plan product that allows consumers to obtain care from accountable care organizations. The program is expected to reduce...

Top 10 Healthcare Insurance Headlines from 2016 Involve Value

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Over the last year, the medical insurance industry has undergone a variety of changes and overcame challenges as the space transitioned to value-based care. Below we outline ten of the most influential healthcare insurance headlines from 2016...

UnitedHealth Adopts Bundled Payment Model for Orthopedic Care

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Healthcare payers are finding that their reimbursement totals show higher spend for hip, knee, and spine surgeries and other orthopedic care when compared to other forms of treatment. Along with the higher spend, members regularly show poor health...

Clinical Data Analytics Key for Value-Based Care Reimbursement

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Many medical facilities have seen how the healthcare industry has been moving away from fee-for-service payment to value-based care reimbursement. Revere Health is one organization that jumped on the bandwagon early on and has quickly moved forward...

Top 3 Trends Affecting the Health Insurance Market in 2016

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Looking back at 2016, there were a number of different trends that continued to impact the health insurance market. The Triple Aim of Healthcare continues to be a major part of the ongoing reforms and trends throughout the insurance industry...

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