Healthcare IT Interoperability, EHR interoperability, Hospital Interoperability

Value-Based Care News

Helping Payers Implement Value-Based Hospital Reimbursement

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Hospitals generate some of the largest revenues and create exceptionally high costs for payers, which combine open the possibility for value-based hospital reimbursement programs to control spending.        In March...

First Steps for Payers Developing Value-Based Care Initiatives

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Successful value-based care initiatives require payers to learn which populations experience a high prevalence of chronic disease, where their organizations overspend, and how value-based contracting can solve these problems. Carefully...

Adding Telehealth, Remote Care Benefits into Health Plan Options

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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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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