Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Care Coordination

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How Payers Can Improve the Value of Long-Term Support Services

by Thomas Beaton

Providing long-term support services (LTSS) impact commercial payers who need to address complications and billions in costs associated with this kind of care. In 2016, the United States spent $92.4 billion on home health care services...

Payers Support Integrated Care Services for NC Medicaid Patients

by Thomas Beaton

Payers and provider organizations that support integrated care systems can help lower healthcare costs by addressing the healthcare concerns of vulnerable patient populations, including Medicaid beneficiaries. Several commercial payers...

Pre-Authorizations, Rx Limits Cut Opioid Abuse by 30% Nationwide

by Thomas Beaton

Anthem BlueCross BlueShield (BCBS) organizations across the country collectively pledged to lower opioid abuse by 30 percent, and the company as a whole reached that goal two years ahead of schedule according to a press release. Declared...

Opioid Use Fell 32% in CA BCBS Prescription Drug Safety Program

by Thomas Beaton

The Blue Shield of California Health Plan, an independent member of Blue Cross Blue Shield (BCBS), successfully lowered overall opioid use by 32 percent during the first two years of its Narcotic Safety Initiative (NSI).   The NSI...

Payers, Providers Collaborate to Combat Opioid Abuse, Addiction

by Jesse Migneault

Insufficient control of opioid prescriptions is one of the key reasons why opioid abuse and addiction have risen dramatically over the past few years.    To mitigate the epidemic, payers have developed programs to directly...

Key Steps for Payers to Improve Population Health Management

by Vera Gruessner

In recent years, population health management has become a larger factor in the success of a health insurance company. With more payers transitioning to value-based care reimbursement platforms, the quality of care and patient outcomes...

How Payers Could Improve Population Health Management with Tech

by Vera Gruessner

When payers transition their reimbursement structures toward a value-based care payment model, healthcare quality improvement needs to be addressed. In order to boost quality, payers could target population health management and data...

Empire BlueCross BlueShield Rewards Strong Care Coordination

by Vera Gruessner

Healthcare payers are often looking for ways to improve care coordination in an effort to enhance patient outcomes and reduce medical spending. Empire BlueCross BlueShield is one healthcare payer that has implemented care coordination...


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