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Considering the Move from MSSP to Medicare Advantage

Over the past several years, the Medicare Advantage program and the Medicare Shared Savings Program (MSSP) have both grown...


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Addressing Data Integrity in Value-Based Care Arrangements—For Payers

This is the final part of a three-part blog series exploring from both a provider and payer perspective the topic of data...


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Embracing Value-Based Contracts - Five Keys to Success for Health Plans

Value-based contracting is a complicated process. Payers need tools that enable their contracting teams to standardize every...


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Value-Based Contract Modeling Automation for Providers

The process of modeling value-based contracts can be painstaking. Acquiring the insights needed to arrange contracts that...


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Addressing Data Integrity in Value-Based Care Arrangements—For Providers

This is part two of a three-part blog series exploring from both a provider and payer perspective a topic that impacts the entire...


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Four Best Practices for Payers to Consider When Contracting for Value-Based Care

Successful value-based care (VBC) contracts are driven by actionable data that informs both the payer and the provider. Payers...


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Challenges in Data Integrity in Value-Based Care Arrangements

This is part one of a three-part blog series exploring from both a provider and payer perspective a topic that impacts the entire...


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Value-Based Care Predictions for 2022

As we leave a tough 2021 in the rear-view mirror, 2022 brings with it some optimism as recent data suggests that vaccinated and...


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Value-Based Contract Financial Reconciliation - Five Key Steps for Health Systems

Timely and accurate financial reconciliation is a critical part of the value-based contracting process and can be the difference...


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The Importance of Specialist Referral Efficiency in Value-Based Care

As risk-bearing entities (Health Plans, ACOs, IPAs, etc.) continue to advance in value-based care (VBC), one area they can’t...


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Tags: Value-Based Care, specialist referral, referral efficiency,

Understanding Big Data in Healthcare: The Three V's

With the rise of risk-bearing arrangements and value-based care, “big data” is becoming more prominent in the sphere of...


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Tags: Value Based Payments

Navigating the Key Components of Value-Based Contracting

During the value-based contracting process, health plan executives should be prepared to do all of the following: evaluate risk...


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Tags: payers, Health Plans, Value-Based Care

VBC Contracting: Challenges and Keys to Success for Health Plans

The number of value-based contracts across the healthcare industry is rapidly increasing, yet many health plans still struggle...


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Tags: Health Plans

Value-Based Contracting: The Role of People, Process and Technology – For Payers

Value-based care (VBC) contracts are here, but how do you, the payer, foster success for both you and your provider network as...


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The Five Principles of Provider Enablement

Building a strong relationship with your provider network is the cornerstone of a successful value-based care (VBC) program, but...


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The Value and Challenges of EMPI

Matching data from multiple disparate information sources to the same unique individual has been and continues to be a challenge...


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Tags: Health Plans, Value-Based Care, EMPI,

Addressing Network Leakage in the Value-Based World

Healthcare Executives know that network leakage, also known as patient or patient referral leakage, is a huge and ongoing issue....


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Tags: Value Based, Health Plans

Value-Based Care Contracting for Risk-Bearing Entities

Risk-bearing entities such as hospital systems, IDNs, and IPAs are central actors in the stage play that is the value-based care...


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Tags: Value Based Payments

Incorporating SDoH into VBC Contracting

A risk bearing entity, whether it is a health plan, an ACO, or an IPA, should consider including SDoH contracting into their...


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Tags: SDOH, Value-Based Care

How Health Plans Can Ensure Capitated Arrangements Succeed

With more and more health plans, like Humana, announcing the development of value-based capitated payment programs, capitated...


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Solving Value-Based Contract Modeling Riddles

Value-based care (VBC) changes the way payers and providers (ACOs, IPAs, etc.) contract with each other. The complexity of the...


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Tags: Value Based Payments, Health Plans

Social Determinants of Health and Their Impact on Value-Based Care

For the past ten years social determinants of Health (SDoH) have gained greater importance from health care organizations and...


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Tags: Value Based Payments, Health Plans, SDOH

What to Expect from a Biden Presidency: VBC Contracting for Health Plans

With a new president in office, the entire country is wondering how one of Biden’s major platforms—healthcare reform—will...


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Tags: Value Based Payments, Health Plans

How Health Plans Can Use Cohort Management for Maximum Impact

Successful value-based care (VBC) programs use cohort management to impact care beyond a clinical level and address many of the...


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Tags: Value Based Payments, Health Plans

Real Time Incentives for Providers to Achieve VBC Goals During COVID-19

Since February 2020, COVID-19 has continued its course throughout the United States. As the year comes to a close, stakeholders...


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Tags: Value Based Payments

CMS CHART Model is Transforming Rural Health

What Does Rural Mean?

The large majority of American land is rural, so it can often feel like a daunting task to define which...


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Tags: Value Based Payments

How a National Patient ID Could Impact Value-Based Care

National patient identification has been a hot topic since HIPAA was enacted in 1996, calling for the development of a unique...


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Tags: Value Based Payments, Health Plans

How Health Plans Can Use SDoH Data to Succeed in Value-Based Care

COVID-19 has reignited the conversation regarding social determinants of health (SDoH) as certain minority groups are at a...


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Tags: Value Based Payments, Health Plans

The Value of Transparency in VBC Contracts

Physicians’ attitudes toward value-based care (VBC) have changed within the last four years. In 2016, the majority of physicians...


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Tags: Value Based Payments, Health Plans

How Health Plans Can Take Value-Based Care from Contract to Practice in 5 Steps

We’ve all had great ideas on paper. But for our endeavors to come to fruition, they need to be successfully implemented. The same...


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Tags: Value Based Payments, Health Plans