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Over the past several years, the Medicare Advantage program and the Medicare Shared Savings Program (MSSP) have both grown...
This is the final part of a three-part blog series exploring from both a provider and payer perspective the topic of data...
Value-based contracting is a complicated process. Payers need tools that enable their contracting teams to standardize every...
The process of modeling value-based contracts can be painstaking. Acquiring the insights needed to arrange contracts that...
This is part two of a three-part blog series exploring from both a provider and payer perspective a topic that impacts the entire...
Successful value-based care (VBC) contracts are driven by actionable data that informs both the payer and the provider. Payers...
This is part one of a three-part blog series exploring from both a provider and payer perspective a topic that impacts the entire...
As we leave a tough 2021 in the rear-view mirror, 2022 brings with it some optimism as recent data suggests that vaccinated and...
Timely and accurate financial reconciliation is a critical part of the value-based contracting process and can be the difference...
As risk-bearing entities (Health Plans, ACOs, IPAs, etc.) continue to advance in value-based care (VBC), one area they can’t...
Tags: Value-Based Care, specialist referral, referral efficiency,
With the rise of risk-bearing arrangements and value-based care, “big data” is becoming more prominent in the sphere of...
Tags: Value Based Payments
During the value-based contracting process, health plan executives should be prepared to do all of the following: evaluate risk...
Tags: payers, Health Plans, Value-Based Care
The number of value-based contracts across the healthcare industry is rapidly increasing, yet many health plans still struggle...
Tags: Health Plans
Value-based care (VBC) contracts are here, but how do you, the payer, foster success for both you and your provider network as...
Building a strong relationship with your provider network is the cornerstone of a successful value-based care (VBC) program, but...
Matching data from multiple disparate information sources to the same unique individual has been and continues to be a challenge...
Tags: Health Plans, Value-Based Care, EMPI,
Healthcare Executives know that network leakage, also known as patient or patient referral leakage, is a huge and ongoing issue....
Tags: Value Based, Health Plans
Risk-bearing entities such as hospital systems, IDNs, and IPAs are central actors in the stage play that is the value-based care...
Tags: Value Based Payments
A risk bearing entity, whether it is a health plan, an ACO, or an IPA, should consider including SDoH contracting into their...
Tags: SDOH, Value-Based Care
With more and more health plans, like Humana, announcing the development of value-based capitated payment programs, capitated...
Value-based care (VBC) changes the way payers and providers (ACOs, IPAs, etc.) contract with each other. The complexity of the...
Tags: Value Based Payments, Health Plans
For the past ten years social determinants of Health (SDoH) have gained greater importance from health care organizations and...
Tags: Value Based Payments, Health Plans, SDOH
With a new president in office, the entire country is wondering how one of Biden’s major platforms—healthcare reform—will...
Tags: Value Based Payments, Health Plans
Successful value-based care (VBC) programs use cohort management to impact care beyond a clinical level and address many of the...
Tags: Value Based Payments, Health Plans
Since February 2020, COVID-19 has continued its course throughout the United States. As the year comes to a close, stakeholders...
Tags: Value Based Payments
What Does Rural Mean?
The large majority of American land is rural, so it can often feel like a daunting task to define which...
Tags: Value Based Payments
National patient identification has been a hot topic since HIPAA was enacted in 1996, calling for the development of a unique...
Tags: Value Based Payments, Health Plans
COVID-19 has reignited the conversation regarding social determinants of health (SDoH) as certain minority groups are at a...
Tags: Value Based Payments, Health Plans
Physicians’ attitudes toward value-based care (VBC) have changed within the last four years. In 2016, the majority of physicians...
Tags: Value Based Payments, Health Plans
We’ve all had great ideas on paper. But for our endeavors to come to fruition, they need to be successfully implemented. The same...
Tags: Value Based Payments, Health Plans