Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Value-Based Care News

Adding Telehealth, Remote Care Benefits into Health Plan Options

May 16, 2018 - Payers that include telehealth and remote care benefits in their health plan options could position themselves as leaders in health plan value, convenience, and innovation. Health plans are challenged to improve customer service and member satisfaction in an industry that has not produced ideal member experiences. Commercial health plans are falling behind other industries in key consumer...


Articles

Commercial Health Plan Customer Satisfaction Remains Steady

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Commercial health plan customer satisfaction rates remained stable from 2017 to 2018, but payers still have a number of opportunities to improve their customer service and beneficiary education, according to a new JD Power consumer survey. The...

Improving Health Plan Customer Service Through Technology

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High quality health plan customer service is critical for payers who want to create meaningful, positive beneficiary interactions. Customer service plays several important roles for health plans.  In addition to the stand-alone goal of leaving...

How Payers Can Address Food Insecurity among Plan Beneficiaries

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Payers are constantly challenged to provide their health plan beneficiaries the best possible healthcare experiences, but may have trouble doing that if members experience food insecurity. Food security is just one lifestyle need that plays into...

Using Social Determinants of Health for Risk Stratification

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Engaging in meaningful risk stratification of beneficiaries requires accurate data that can highlight opportunities to reduce costs and improve outcomes for plan members. In order for payers to develop accurate and detailed risk stratification...

86% of Employers Use Financial Incentives in Wellness Programs

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Eighty-six percent of employers offer financial incentives in their wellness programs, according to a new survey from the National Business Group on Health (NBGH) and Fidelity Investments.  This represents an 11 percent increase since 2017,...

64% of Employees Say Financial Incentives Boost Member Engagement

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Sixty-four percent of employees that participated in a new survey said financial incentives helped connect them to necessary healthcare resources and equip them for improved member engagement. The Clear Insights Survey fielded by Wex Health and...

Medicare Advantage Data Transparency Can Enhance Insights

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Expanding Medicare Advantage data transparency may allow researchers to gain more comprehensive insights into cost and quality within the popular MA program. Healthcare experts and academic organizations currently have limited Medicare Advantage...

How Payers Address Deep-Rooted Social Determinants of Health

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The social determinants of health (SDOH) have gained traction in payer discussions and are driving payers to take a thoughtful look into factors that create long-lasting effects on healthcare costs and outcomes. Payers recently have implemented...

Bundled Payments Require Clinical Insights, Provider Buy-In

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Payers see bundled payments as a way to promote value-based reimbursement practices but must first leverage clinical insights and provider buy-in to maximize a bundle’s potential effectiveness. Bundled payments are valuable to payers because...

AMA Promotes Alternative Payment Model for Opioid-Use Disorder

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The American Society of Addiction Medicine (ASAM) and the American Medical Association (AMA) have announced plans to promote an alternative payment model to address opioid use disorder. Leaders at ASAM and AMA are encouraging payer and provider...

How Payers Can Add More Value to Medicare Advantage Health Plans

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Payers striving to compete in the Medicare Advantage (MA) market can add more value to their health plans by taking advantage of regulatory changes established under a new final rule. Starting in plan year 2019, payers can offer a greater variety...

CVS Health Offers New Tools for Lowering Prescription Drug Costs

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CVS Health has launched new cost-saving initiatives that aim to lower beneficiary prescription drug costs through co-pay adjustments, pricing transparency technology, and increased promotion of generic drugs. The initiatives follow a CVS Health...

CMS: Mix of Racial, Ethnic Disparities in Medicare Advantage

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CMS found significant racial and ethnic disparities related to patient experience and chronic disease management in the Medicare Advantage (MA) program, revealing potential health equity concerns within MA. A report published by CMS and the RAND...

JP Morgan: Value-Based Care Will Guide Amazon, Berkshire Work

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Amazon, JP Morgan, and Berkshire Hathaway will build their new company upon best practices in value-based care, including improving preventive care and managing member costs through data sharing, said JP Morgan Chase & Co. CEO Jamie Dimon...

Regional Differences Seen in High-Deductible Health Plan Volume

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Regional differences in high-deductible health plan (HDHP) volume and other health plan offerings may help employers adjust insurance offerings in ways that are more valuable to their employees, according to a new report from Benefitfocus. The...

How Payers Address the Nation’s Opioid Crisis, Patient Safety

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Commercial payers leverage community financing and engagement techniques to limit patient safety risks related to the nation’s opioid crisis. Payers find that contributing information to datasets can help stakeholders detect opioid risks...

Payers Add Preventive Care, Wellness to Holistic Health Solutions

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Payers have developed several initiatives to incorporate preventive care and wellness as part of their larger holistic health solutions. Adding wellness and preventive care can help payers keep their beneficiaries from developing costly chronic...

BCBS Association: Use Alternative Pain Therapies Before Opioids

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The BlueCross BlueShield Association (BCBSA) has announced a new professional standard that removes opioid prescriptions as a primary pain treatment in a majority of clinical situations. The payer’s National Council of Physician and Pharmacist...

Health Plan Data Governance Assists Value-Based Reimbursement

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Health plan data governance plays a key role in overcoming barriers related to industry-wide adoption of value-based reimbursement, according to a two-year study conducted by CAQH CORE.  Health plans are industry leaders who should take...

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