Payer input is critical for developing high performance networks (HPNs) that are efficient and cost-effective while delivering high quality care, says the Academy of Actuaries in a new report....
Value-based care helped close 50 million gaps in care between 2013 and 2017 while reducing care costs, lowering ED utilization, and increasing provider care quality, according to a new report from...
HCSC is investing $1.5 billion to develop health insurance affordability solutions including employee wellness programs, ways to address social determinants of health, and collaborative care.
Dubbed...
Philadelphia-based Health Partners Plan (HPP) reduced blood glucose levels of diabetics and care utilization of other chronically ill members by implementing a healthy meal program to address...
Payer-provider collaboration, holistic healthcare approaches that address the social determinants of health (SDOH), and the use of health IT tools will be among the most important drivers of...
UnitedHealth Group will help support a new Medicare bundled payment program by offering data and analytics services to participating providers.
The payer announced in a press release that it will...
NCQA is seeking health plan, provider, and related stakeholder public comments to weigh in on updated HEDIS measures and the implementation of new measures related to chronic disease management.
NCQA...
Seventy percent of executives participating in a survey conducted by Humana and HFMA believe that the need for interoperability and seamless data sharing will be required for payers and providers to...
Eighty percent of payers believe that addressing the social determinants of health (SDOH) of their beneficiary populations will be a key way to improve their population health programs, according to a...
An all-payer claims database (APCD) can hold data on millions of patients and the services they receive, giving payers, providers, and related stakeholders the ability to identify wasteful spending and...
Commercial payers struggling to curb costs and encourage their members to make smarter financial choices may be able to save millions of dollars each year by investing in modest member...
Delaware’s Department of Health and Social Services (DHSS) announced it is translating the state’s managed Medicaid Contracts into value-based agreements to improve the outcomes and costs...
Payers may be more willing to provide their beneficiaries with genetic drug therapies that costs hundreds of thousands of dollars if they enter into outcomes-based pharmaceutical contracts that lessen...
The American Academy of Physicians, Aledade, the Texas Medical Association, Iora Health, and the Medical Group Management Association (MGMA) are among provider advocates urging CMS to create more...
Healthcare payers may find it difficult to establish value-based contracts (VBCs) with pharmaceutical companies due to the challenges of creating meaningful, workable quality measures....
Payers looking for innovative ways to control the costs of care have been turning their attention to the social determinants of health, the non-clinical factors that often lead to issues with care...
Healthcare payers and providers must develop a better sense of the costs and burdens of implementing quality measures if they are to succeed with value-based care, according to the authors of a recent...
Accountable care organizations in the Medicare Shared Savings Program (MSSP) lowered net spending by $1 billion and could help control high expected Medicare spending in the future, a report from the...
As payers and employers learn to counter significant increases of prescription drug expenses, reference pricing may hold the key to lowering drug spending and increasing consumer purchases of lower...
Tufts Health Plan has signed contracts to form Medicaid accountable care organizations (ACOs) with Atrius Health, Beth Israel Deaconess Care Organization, Cambridge Health Alliance, and Boston...
