Value-Based Care News

How Payers Leverage Apps to Improve Type 2 Diabetes Management

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In October 2021, Capital Blue Cross strengthened its Type 2 diabetes management efforts by introducing two new apps to its members, apps that could enable them to prevent and potentially reverse the...

Behavioral Health, Physical Health Worsen Among Women, Children

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While many health behaviors in women of reproductive age and children have improved in recent years, behavioral health and physical health have declined and uninsurance rose, according to a...

How Benefit Design Can Steer Employees Toward High-Value Care

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When pursuing value-based care, employers have the capacity—in collaboration with their payer or third-party administrator partners—to steer their employees toward high-value care,...

How Employers Can Control Costs with Episode-Based Benefit Plans

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As employers strive to help members lower costs, they can leverage episode-based benefit plans to guide their employees toward value-based care decision-making, according to a report from Manatt...

5 Steps Employers Can Take To Implement Advanced Primary Care

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Advanced primary care can help employers control costs and coordinate care, but many employers do not know how to start and scale such a solution in their employer-sponsored health plans, according to...

The State of Payer, CBO Social Determinants of Health Contracting

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Social determinants of health contracting with community-based organizations remains a complex and challenging task for payers as the demand for answers grows more pressing. As the industry’s...

3 Strategies for Sustaining Payer Innovation Momentum Post-COVID

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The coronavirus pandemic set off a whirlwind of payer innovation, largely out of necessity. In the health insurance world specifically, payers continued to advance new products during the pandemic....

Top 3 Member Engagement Benefits of Using Omnichannel Tools

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Omnichannel strategies are becoming increasingly significant to successful member engagement. What is omnichannel engagement? Omnichannel engagement is a strategy that originated as a sales and...

How Ambulatory Surgery Centers Lower Payer Outpatient Spending

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Ambulatory surgery centers can be high value care sites for hospital outpatient services, according to UnitedHealth Group’s recent claims analysis. Ambulatory surgery centers are care sites that...

Essential Home Healthcare Quality Measures for Value-Based Care

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As home healthcare becomes more common, payers pursuing value-based care arrangements with home healthcare providers will need to establish strong home healthcare quality measurements. The coronavirus...

Employers: Mental Health, Chronic Disease Needs Will Rise in 2022

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Employers are anticipating that the coronavirus pandemic will continue to have a long-term impact in 2022, particularly in the areas of mental health and chronic disease needs, according to Business...

Unvaccinated COVID-19 Hospitalizations Drive Up Healthcare Spend

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Unvaccinated COVID-19 hospitalizations cost payers and the healthcare system at large billions in healthcare spending, according to a Peterson-Kaiser Family Foundation (KFF) Health System Tracker...

Value-Based Care Challenges, Opportunities for Payers in 2021

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As payers continue to manage the coronavirus pandemic in 2021, this unique period in history presents alternative payment model and value-based care challenges and opportunities that are beginning to...

5 Ways Payers Have Tackled Mental, Behavioral Healthcare in 2021

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In the wake of the coronavirus pandemic, payers have focused on improving and implementing mental and behavioral healthcare programs. From January to June 2019, 11 percent of US adults reported...

Why Catastrophic Medicare Part D Drug Spending Is On The Rise

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For over a decade, an increasing number of Medicare beneficiaries have shouldered catastrophic Medicare Part D drug spending that exceeds the catastrophic threshold, according to a recent Kaiser Family...

How Payers Can Support Population-Based Payment Model Uptake

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As the healthcare industry gravitates toward value-based care, population-based payment models have become the golden fleece for payers, the ultimate state of value-based care payment. Unfortunately...

How Payers Can Improve Cancer Patient Navigation, Experience

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As executive director of state government affairs at the Leukemia and Lymphoma Society (LLS), Lucy Culp has heard a common refrain from cancer patients: securing treatment and coverage has become a...

How Employers Can Influence Employee Coronavirus Vaccine Uptake

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Employers play a key role in increasing coronavirus vaccine uptake, but not necessarily by requiring workers to receive the vaccine, a recent Kaiser Family Foundation (KFF) report...

87% of Eligible Seniors Do Not Receive Lung Cancer Screenings

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Seniors who do not have coverage for lung cancer screenings as a preventive service are less likely to receive the screening, a recent study from Epic Health Research Network (EHRN) found. EHRN...

Racial Care Disparities May Be Lower in Medicare Advantage Plans

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Medicare Advantage plans may better address racial care disparities than fee-for-service Medicare, according to the second in a series of reports that ATI Advisory has prepared for Better Medicare...